Organization
HOSPITAL OF FULTON, INC.
Active
Parent organization
HOSPITAL OF FULTON, INC.
Other names
Hickman-Fulton County Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOSPITAL OF FULTON, INC.
Authorized official
LAURIE HOLTSFORD (AUTH OFF / DIR BUSINESS OF FICE SUP)
(615) 465-7466
Entity
Organization
Contact information
Practice address
2003 S 7TH ST, HICKMAN, KY 42050-1841
(270) 236-3202
(270) 236-9597
Mailing address
PO BOX 60985, SAINT LOUIS, MO 63160-0985
(270) 236-3202
(270) 236-9597
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
900142
KY
363L00000X
Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
295172
BCBS
KY
05
—
35001387
—
KY
Enumeration date
03/09/2006
Last updated
10/19/2010
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