# GAY FULKERSON,M.D.,P.S.C.

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

## Provider details

- **NPI number:** 1871608323
- **Authorized official:** DR. GAY FULKERSON M.D. (PRESIDENT)
- **Authorized official phone:** (270) 259-9633

## Contact information

- **Practice address:** 310 S MAIN ST, LEITCHFIELD, KY 42754-1428
- **Practice address phone:** (270) 259-9633
- **Practice address fax:** (270) 259-0061
- **Mailing address:** 310 S MAIN ST, LEITCHFIELD, KY 42754-1428
- **Mailing address phone:** (270) 259-9633
- **Mailing address fax:** (270) 259-0061

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 30387 | KY | Yes |

## Other

- **Enumeration date:** 08/21/2006
- **Last updated:** 08/27/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 64303878 | — | KY |