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Individual

DR. GAY FULKERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
310 S MAIN ST, LEITCHFIELD, KY 42754-1428
(270) 259-9633
(270) 259-0061
Mailing address
310 S MAIN ST, LEITCHFIELD, KY 42754-1428
(270) 259-9633
(270) 259-0061

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30387
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000051584
ANTHEM
KY
01
080095920
RAILROAD MEDICARE
KY
05
64303878
KY
Enumeration date
08/21/2006
Last updated
08/12/2024
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