Organization
24 ON PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN A. FULLER (SECRETARY)
(770) 740-0895
Entity
Organization
Contact information
Practice address
1600 11TH ST, WICHITA FALLS, TX 76301-4300
(940) 764-3983
(940) 764-3978
Mailing address
PO BOX 403631, ATLANTA, GA 30384-3631
(770) 740-0895
(770) 740-0896
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Enumeration date
04/10/2007
Last updated
06/04/2015
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