Organization
FULTON G. DE FOUR, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FULTON G DE FOUR M.D. (OWNER)
(251) 752-8235
Entity
Organization
Contact information
Practice address
750 MORPHY AVE, FAIRHOPE, AL 36532-1812
(251) 752-8235
Mailing address
10 N SECTION ST # 161, FAIRHOPE, AL 36532-2205
(251) 752-8235
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22716
AL
Other
Enumeration date
06/25/2010
Last updated
06/25/2010
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