Healthcare Provider Details

I. General information

NPI: 1902018377
Provider Name (Legal Business Name): JOY MARIE FULBRIGHT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2007
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 GILLHAM RD
KANSAS CITY MO
64108-4619
US

IV. Provider business mailing address

310 E 70TH TER
KANSAS CITY MO
64113-2542
US

V. Phone/Fax

Practice location:
  • Phone: 816-234-3395
  • Fax: 816-855-1700
Mailing address:
  • Phone: 602-692-8104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0433236
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number04-33236
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number2010010943
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: