Individual
DR. THOMAS ALLEN FULKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D., LP
Contact information
Practice address
1350 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4376
(417) 761-5850
(417) 761-5851
Mailing address
1350 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4376
(417) 761-5850
(417) 761-5851
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2018005289
MO
103TC0700X
Clinical Psychologist
3962
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490052834
—
MO
Enumeration date
11/11/2008
Last updated
03/05/2026
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