Individual
DR. KEITH FULLING
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
660 OFFICE PKWY, SAINT LOUIS, MO 63141-7103
(314) 991-8015
(314) 991-0691
Mailing address
660 OFFICE PKWY, SAINT LOUIS, MO 63141-7103
(314) 251-4715
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
Primary
R7641
MO
207ZN0500X
Neuropathology Physician
R7641
MO
207ZP0101X
Anatomic Pathology Physician
R7641
MO
Other
Enumeration date
05/12/2006
Last updated
09/11/2025
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