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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

PHILLIP TYLER FULLER, M.D.

Active

PHILLIP TYLER FULLER, M.D. is a Urology healthcare provider located in ADA, Oklahoma. NPI 1871720300 is currently active in the NPPES registry. Verify at CMS.

Urology · ADA, OK

Registration Details

NPI Number
1871720300
Provider Type
Individual
Gender
Male
NPI Issued
Jun 11, 2009 (17.193652187801 yrs)
Last Updated
Jun 25, 2014
License
30483 (OK)

Practice Information

Address
1414 ARLINGTON STREET
SUITE 2300
ADA, OK, 74820
Browse OK providers · Browse ZIP 74820
Phone
5803320112
Fax
5803321005
Primary Specialty
Urology
208800000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.