Doctor Name: | DR. LATOYA DENISE FULTON |
NPI Number: | 1598031122 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O. |
License Number: | 3990200000X |
Business Practice Address: | 620 S Madison St Suite 209 Enid, OK - 737017273 |
Business Phone Number: | 5805481544 |
Business Fax Number: | 5805481590 |
Mailing Address: | 5300 N Independence Ave, 280 OKLAHOMA CITY |
State: | OK |
Postal Code: | 731125556 |
Phone Number: | 5805481544 |
Fax Number: | 5805481590 |
NPI Enumeration Date: | 03/28/2012 |
NPI Last Update Date: | 01/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 3990200000X |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |