| Gay Fulkerson,m.d.,p.s.c. | |
|
310 S Main St Leitchfield KY 42754-1428 | |
| (270) 259-9633 | |
| (270) 259-0061 |
| Full Name | Gay Fulkerson,m.d.,p.s.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 310 S Main St, Leitchfield, Kentucky |
| Authorized Official Name and Position | Gay Fulkerson (PRESIDENT) |
| Authorized Official Contact | 2702599633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gay Fulkerson,m.d.,p.s.c. 310 S Main St Leitchfield KY 42754-1428 Ph: (270) 259-9633 | Gay Fulkerson,m.d.,p.s.c. 310 S Main St Leitchfield KY 42754-1428 Ph: (270) 259-9633 |
| NPI Number | 1871608323 |
|---|---|
| Provider Enumeration Date | 08/21/2006 |
| Last Update Date | 04/28/2008 |
| Medicare PECOS PAC ID | 1850580374 |
|---|---|
| Medicare Enrollment ID | O20110113000708 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871608323 | NPI | - | NPPES |
| 64303878 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 30387 (Kentucky) | Primary |
| Provider Name | Gay Fulkerson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740395292 PECOS PAC ID: 5890984322 Enrollment ID: I20110113000792 |
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