Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jonathan Daniel Fullner, MD

Individual provider Internal Medicine Physician · NPI 1427310523

Dr. Jonathan Daniel Fullner, MD is a Diagnostic Radiology in Phoenix, Arizona. Graduated from University of Nebraska College of Medicine in 2012, 14 years ago. Practices with Bryan Medical Center, a 49-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona and Nebraska.

Years since qualifying
14
Trained at
University of Nebraska College of Medicine
Licensed in
AZ, NE
In the registry since
2012
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone: (602) 406-7783
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 601 N 30th St, Omaha, NE 68131-2137 — (402) 449-4753

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 54143 (AZ)
Internal Medicine Physician Taxonomy 207R00000X · Licence 6773 (NE)
Neuroradiology Physician Taxonomy 2085N0700X · Licence 54143 (AZ)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 28782 (NE)

Record details

NPI number1427310523
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 13, 2012
Last updated in NPPESMarch 17, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolUNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduated 2012 (14 years in practice)
Group practice Bryan Medical Center — 49 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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