PHILLIP TYLER FULLER (NPI# 1871720300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871720300 |
| Entity Type | Individual |
| Full Name | PHILLIP TYLER FULLER |
| Credential | M.D. |
| Practice Address |
1414 Arlington Street Suite 2300 Ada OK 74820 |
| Practice Telephone | 5803320112 |
| Practice Fax Number | 5803321005 |
| Mailing Telephone | 5803320112 |
| Mailing Fax Number | 5803321005 |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2014-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 30483 | OK | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184892978 | Phillip Allen Fuller | Pulmonary Function Technologist | 130e.pondella Dr., Enterprise, AL 36330 | 2008-02-14 |
| Street Address |
1414 ARLINGTON STREET SUITE 2300 |
| City | ADA |
| State | OK |
| Zip Code | 74820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972050052 | Ada Medical Inc | Physical Therapist | 1414 Arlington Street, Suite 2300, Ada, OK 74820 | 2016-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578103727 | Curry Orthopedics and Sports Medicine Pllc | Orthopaedic Surgery | 919 Colony Drive, Ada, OK 74820 | 2020-01-15 |
| 1215574603 | Miranda Denise Bowman | Counselor | 1300 Hoppe Blvd., Suite 5, Ada, OK 74820 | 2019-12-04 |
| 1326509654 | Patricia June Harjo | Case Manager/Care Coordinator | Nittak Himitta' Women's and Children's Recovery Center, 2024 Te Ata Drive, Ada, OK 74820 | 2019-03-28 |
| 1649737172 | Rylee Nikole Leblanc | Case Manager/Care Coordinator | 1119 S High School St, Ada, OK 74820 | 2019-02-20 |
| 1891251328 | David Kinback | Rehabilitation Counselor | 1400 Hoppe Blvd., Suite 3, Cn Recovery Resource Services, Ada, OK 74820 | 2019-02-20 |
| 1922571009 | Central Oklahoma Family Medical Center, Inc. | Pharmacy | 905 Colony Dr, Ada, OK 74820 | 2019-01-10 |
| 1063988673 | Central Oklahoma Family Medical Center, Inc | Clinic/Center | 905 Colony Drive Bldg, Ada, OK 74820 | 2018-10-22 |
| 1265907885 | Apex Surgery Center, LLC | Surgery | 2001 Cradduck Road, Ada, OK 74820 | 2018-10-10 |
| 1689150898 | Sabrina Simmons | Social Worker | 2516 Oakhurst Dr Apt E, Ada, OK 74820 | 2018-07-11 |
| 1700370467 | Brianna Leigh Youngwolfe | Nurse Practitioner | 2020 Arlington St Ste 6, Ada, OK 74820 | 2018-06-17 |
| Find all providers in zip 74820 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194338426 | Davis Urology, Pllc | Urology | 13509 N Meridian Ave Ste 6, Oklahoma City, OK 73120-8396 | 2020-08-26 |
| 1073146304 | Roy W Bankhead Md PC | Urology | 5700 N Portland Ave Ste 100, Oklahoma City, OK 73112-1662 | 2020-02-14 |
| 1851877567 | Richard E. Herlihy Md, PC | Urology | 4140 W Memorial Rd Ste 611, Oklahoma City, OK 73120-8300 | 2018-07-16 |
| 1306383849 | Urology Affiliates of Oklahoma LLC | Urology | 5300 N Grand Blvd Ste 200, Oklahoma City, OK 73112-5517 | 2017-01-23 |
| 1285015057 | Caitlin Shepherd | Urology | 722 Nw 28th St, Oklahoma City, OK 73103-1009 | 2015-06-17 |
| 1295174969 | Joseph Fernando Rodriguez IIi | Urology | 920 Stanton L Young Blvd # Wp3150, Oklahoma City, OK 73104-5036 | 2013-06-17 |
| 1003159773 | Philip D. Diggdon Sr. | Urology | 3424 E. 65 St, Tulsa, OK 74136 | 2013-04-01 |
| 1811247885 | Melanie Nyeh Ketchandji | Urology | 1145 South Utica Avenue, Suite 202, Tulsa, OK 74104-4022 | 2012-09-17 |
| 1992055990 | Kathryn Griffin Cunningham | Urology | 4140 W Memorial Rd Ste 208, Oklahoma City, OK 73120 | 2012-09-17 |
| 1477847374 | Bhalaajee Meenakshi-sundaram | Urology | 1200 Childrens Ave # 7d, Oklahoma City, OK 73104 | 2011-06-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.