Healthcare Provider Details

I. General information

NPI: 1922100122
Provider Name (Legal Business Name): HOSPITAL OF FULTON INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 10/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 HOLIDAY LN SUITE 100
FULTON KY
42041-8468
US

IV. Provider business mailing address

PO BOX 1320
FULTON KY
42041-0320
US

V. Phone/Fax

Practice location:
  • Phone: 270-472-1612
  • Fax: 270-472-2095
Mailing address:
  • Phone: 270-472-1612
  • Fax: 270-472-2095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateKY

VIII. Authorized Official

Name: SOPHIA L ARWOOD
Title or Position: DIRECTOR PHYSICIAN OPERATIONS
Credential:
Phone: 615-628-6038