Organization
FULTON FAMILY HEALTH ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JAIME MOTES (OFFICE MANAGER)
(573) 642-1990
Entity
Organization
Contact information
Practice address
2613 FAIRWAY DR, SUITE C, FULTON, MO 65251-3936
(573) 642-1990
(573) 642-1866
Mailing address
2613 FAIRWAY DR, SUITE C, FULTON, MO 65251-3936
(573) 642-1990
(573) 642-1866
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
504746603
—
MO
Enumeration date
07/04/2006
Last updated
12/17/2008
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