LOUIS M FULTON


Address: 1300 South Drive, Winnebago Mental Health Information, Winnebago, WI 54985-0009
Phone: 9202354910

LOUIS M FULTON (NPI# 1093702383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1093702383
Entity Type Individual
Full Name LOUIS M FULTON
Credential MD
Practice Address 1300 South Drive
Winnebago Mental Health Information
Winnebago
WI 54985-0009
Mailing Address 1300 South Drive
Winnebago
WI 54985
Practice Telephone 9202354910
Practice Fax Number 9202352931
Mailing Telephone 9202354910
Mailing Fax Number 9202372043
Enumeration Date 2005-10-01
Last Update Date 2018-05-11
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084P0804X Psychiatry & Neurology
Specialization: Child & Adolescent Psychiatry
41378 MN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MN 626325900 05

Office Location

Street Address 1300 SOUTH DRIVE
WINNEBAGO MENTAL HEALTH INFORMATION
City WINNEBAGO
State WI
Zip Code 54985-0009

Providers in the same location

NPI Name Taxonomy Address Enumeration
1225320005 Konstantin A Mikheyev Family Medicine 1300 South Drive, Winnebago, WI 54985-0009 2011-05-11
1992028948 Kaye Zwiacher Psychiatry & Neurology 1300 South Drive, Winnebago, WI 54985 2010-03-04
1417189135 Kevin K Klein Nurse Practitioner 1300 South Drive, Winnebago, WI 54985-0009 2009-08-13
1669627089 Anthony M Lichtfuss Social Worker 1300 South Drive, Winnebago, WI 54985 2008-11-26
1598984346 Kayla M Pope Psychiatry & Neurology 1300 South Drive, Winnebago, WI 54985-0009 2007-04-24
1962626317 Kent M Berney Psychologist 1300 South Drive, Winnebago, WI 54985-0009 2007-04-13
1255451688 Clifford K Stephens Psychologist 1300 South Drive, Winnebago, WI 54985-0009 2007-03-30
1669505996 Margaret Lehnert Dentist 1300 South Drive, Winnebago, WI 54985-0009 2007-03-14
1750425328 Michele A. Andrade Psychiatry & Neurology 1300 South Drive, Winnebago, WI 54985 2007-02-16
1952455800 Jeremiah Lee Olson Counselor 1300 South Drive, Winnebago, WI 54985-0009 2007-01-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437315538 Emerald M Hauser Student in an Organized Health Care Education/Training Program 1300 South Treffert Drive, Winnebago, WI 54985 2008-07-29
1427231828 Carlo Gallo Gaanan Family Medicine 1505 North Drive, Winnebago, WI 54985 2007-12-10
1588781488 Paul J Barfknecht Pharmacist 1300 South Dr, Winnebago, WI 54985 2007-03-23
1265924161 Jeremiah Mobisa Gwaro Nurse Practitioner 1505 North Drive, Winnebago, WI 54985 2018-06-06
1932630985 Thomas Michlowski Psychiatry & Neurology 1505 North Drive, Winnebago, WI 54985 2017-03-22
1295094571 Julie Ann Thiel Pharmacist 1505 North Drive, Winnebago, WI 54985 2012-05-08
1124270947 Adam Matthew Berman Psychologist 2901 W Kinnickinnic River Parkway, Ste 516 Medical Psychology Association, Milwaukee, WI 54985 2008-10-13
1225214802 Dara B. Sitter Pharmacist 1300 South Dr., Winnebago, WI 54985 2008-01-14
1083825608 Kelly Lee Straus-diedrick Physical Therapist 725 Butler Ave, Winnebago, WI 54985 2007-05-25
1093864993 Byron J Krause Speech-Language Pathologist 725 Butler Ave, Oshkosh, WI 54985 2007-01-09
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Taxonomy Information

Taxonomy Code 2084P0804X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Child & Adolescent Psychiatry

Taxonomy Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1598984346 Kayla M Pope Psychiatry & Neurology 1300 South Drive, Winnebago, WI 54985-0009 2007-04-24

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1104384387 Center for Emotional Wellness LLC. Psychiatry & Neurology W156n8327 Pilgrim Rd Ste 301, Menomonee Fls, WI 53051-3776 2019-03-06
1295000255 Ilsa Bick Psychiatry & Neurology 1099 Highland Dr, Kohler, WI 53044-1306 2012-03-09
1215268453 Richard Carl Zimmerman Psychiatry & Neurology 1282 E. Green Lake Dr., West Bend, WI 53090-9069 2010-01-28
1184800880 William M Buzogany Psychiatry & Neurology W350 S1401 Waterville Road, Lad Lake Inc, Dousman, WI 53118 2008-01-14
1033300199 Monika Drummond Roots Psychiatry & Neurology 3140 Oxford Rd, Madison, WI 53705-2224 2007-08-05
1598974321 Marta Cristina Muller Psychiatry & Neurology 1941 N Battle Creek Rd, Oconomowoc, WI 53066-9468 2007-05-21
1164517082 Moitreyee Bandyopadhyay Reddy Psychiatry & Neurology 9000 W.wisconsin Avenue, Milwaukee, WI 53201-1997 2006-10-04
1639182868 Thomas E. Wright Psychiatry & Neurology 120 East Main Street, Cambridge, WI 53523-0548 2006-08-15
1447262183 Neil P Fullan Psychiatry & Neurology 2475 University Ave Ste A, Green Bay, WI 54302-5099 2006-08-12
1396761276 Robert Perzacki Psychiatry & Neurology 1820 Appleton Rd, Menasha, WI 54952-1110 2006-07-14
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Competitor

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City WINNEBAGO
Zip Code 54985

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Dataset Information

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.

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