Individual
SAMANTHA A FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 NE 13TH ST, OKLAHOMA CITY, OK 73104-5004
(405) 830-1868
Mailing address
4400 S CZECH HALL RD, MUSTANG, OK 73064-9571
(405) 830-1868
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1246960
OK
Other
Enumeration date
06/19/2026
Last updated
06/19/2026
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