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Contact Information

PHILLIP T FULLER, MD
1414 ARLINGTON STREET
SUITE 2300
ADA, OK74820
 Phone: 580-332-0112
 Fax: 580-332-1005
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Urology

208800000X 34 Physician/Urology
Indicates primary specialty

NPI Profile & details for PHILLIP T FULLER · (Male)

NPI Number 1871720300
Status Active
Credentials MD
Entity Individual
Enumeration date 06/11/2009
Last updated 06/25/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • OK License # 30483
Hospital affiliation(s)
  • CHICKASAW NATION MEDICAL CENTER - (Acute Care)
    1921 STONECIPHER BLVD
    ADA, OK 74820
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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