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

Paul Fulghum, ODPA

Individual provider Optometrist · NPI 1962436121

Paul Fulghum, ODPA is an Optometrist in Jacksonville, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2006
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Practice location Address checks out

4225 Lakeside Dr
Jacksonville, FL 32210-3305
Phone: (904) 387-5704
Fax: (904) 387-5751
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 1834 (FL)

Record details

NPI number1962436121
Entity typeIndividual (Type 1)
GenderMale
Credentials ODPA
Sole proprietorYes
NPI enumeratedJuly 11, 2006
Last updated in NPPESNovember 29, 2023

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