Individual
FULTON G DEFOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
750 MORPHY AVE, FAIRHOPE, AL 36532-1812
(251) 990-1922
Mailing address
1725 SPRING HILL AVE, MOBILE, AL 36604-1402
(251) 435-1366
(251) 435-1616
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
22716
AL
208M00000X
Hospitalist Physician
Primary
22716
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11045567
CAQH
—
Enumeration date
12/13/2005
Last updated
07/01/2019
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