# FULTON FAMILY HEALTH ASSOCIATES, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225068455
- **Authorized official:** MISS JAIME MOTES (OFFICE MANAGER)
- **Authorized official phone:** (573) 642-1990

## Contact information

- **Practice address:** 2613 FAIRWAY DR, SUITE C, FULTON, MO 65251-3936
- **Practice address phone:** (573) 642-1990
- **Practice address fax:** (573) 642-1866
- **Mailing address:** 2613 FAIRWAY DR, SUITE C, FULTON, MO 65251-3936
- **Mailing address phone:** (573) 642-1990
- **Mailing address fax:** (573) 642-1866

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/04/2006
- **Last updated:** 12/17/2008