Fullingim, Dean Roy
Fullingim, Dean Roy is an individual health care provider with primary practice located at 744 W 9Th St , Tulsa OK 74127-9020. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Fullingim, Dean Roy can be contacted via phone (918) 728-6194.Contact Information
Primary practice address
744 W 9Th St
Tulsa OK 74127-9020
Phone: (918) 728-6194
Fax: (918) 664-2521
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 1610 | Oklahoma |
Profile Details
| NPI number | 1770574253 |
|---|---|
| LBN Legal business name | Fullingim, Dean Roy |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | Mar 28th, 2017 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770574253 | NPPES |
| Oklahoma | MEDICAID | 100093690A |
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