Fulks, Kenneth Dwayne

Fulks, Kenneth Dwayne is an sole proprietor health care provider with primary practice located at 1601 Hatcher Ln , Columbia TN 38401-4826. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Fulks, Kenneth Dwayne can be contacted via phone (931) 381-2802.

Contact Information

Primary practice address
1601 Hatcher Ln Columbia TN 38401-4826
Phone: (931) 381-2802
Fax: (931) 388-0719
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X MD019595 Tennessee

Profile Details

NPI number 1144237751
LBN Legal business name Fulks, Kenneth Dwayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 3rd, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1144237751 NPPES
Tennessee MEDICAID 3059467

Popular Providers