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General NPI Number Information
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NPI Number | 1992987861
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Entity Type | Organization
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Legal Business Name | THOMAS W. FULBRIGHT M.D. P.A.
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Dates
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Enumeration Date | 12/03/2007
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Last Update Date | 09/12/2011
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Provider Practice Location Address
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Address Line | 8901 W 74TH ST
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City | SHAWNEE MISSION
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State | KS
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Zip | 66204-2204
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Country | US
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Telephone | 913-261-2222
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Fax | 913-261-2229
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Provider Business Mailing Address
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Address Line | 8901 W 74TH ST, SUITE 2
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City | SHAWNEE MISSION
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State | KS
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Zip | 66204-2204
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Country | US
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Telephone | 913-261-2222
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Fax | 913-261-2229
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. JOHN APPLEBY
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Credential | M.B.A.
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Telephone | 913-261-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 0421442
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License Number State | KS
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