Dr. Kenneth Dwayne Fulks, M.D.
Surgery, Plastic and Reconstructive Surgery in Columbia, TN. Individual provider (NPI-1).
NPI number1144237751
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1144237751
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kenneth Dwayne Fulks
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 3, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086S0122X | Surgery, Plastic and Reconstructive Surgery | MD019595 | TN | Yes |
Practice location
1601 Hatcher LnColumbia, TN 38401-4826
Phone 931-381-2802 · Fax 931-388-0719
Mailing address
1601 Hatcher LnColumbia, TN 38401-4826
Phone 931-381-2802 · Fax 931-388-0719
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