DR. KENNETH DWAYNE FULKS


Address: 1601 Hatcher Ln, Columbia, TN 38401-4826
Phone: 9313812802

DR. KENNETH DWAYNE FULKS (NPI# 1144237751) 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) 1144237751
Entity Type Individual
Full Name DR. KENNETH DWAYNE FULKS
Credential M.D.
Practice Address 1601 Hatcher Ln
Columbia
TN 38401-4826
Practice Telephone 9313812802
Practice Fax Number 9313880719
Mailing Telephone 9313812802
Mailing Fax Number 9313880719
Enumeration Date 2006-08-03
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0122X Surgery
Specialization: Plastic and Reconstructive Surgery
MD019595 TN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TN 3059467 05

Office Location

Street Address 1601 HATCHER LN
City COLUMBIA
State TN
Zip Code 38401-4826

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1093327629 Andrew Swensen Pharmacist 1202 South James Campbell Blvd, Columbia, TN 38401 2020-08-17
1790305522 Milaya L Webster Community Based Residential Treatment Facility, Mental Illness 809 South Water Streer, Columbia, TN 38401 2020-04-22
1730729468 Dania Cortez Licensed Practical Nurse 40 Park Plus Court, Columbia, TN 38401 2020-01-10
1619519683 Agilitas Usa, Inc Clinic/Center 627 S. James Campbell Blvd., Suite B, Columbia, TN 38401 2019-10-11
1710531280 Abby Graves Dietitian, Registered 1216 Trottwood Ave, Columbia, TN 38401 2019-08-01
1942771746 James Brian Gregory Marriage & Family Therapist 497 E James Campbell Blvd, Columbia, TN 38401 2018-12-06
1104312255 Sarah Miller Social Worker 230 E James Campbell Boulevard, Suite 113, Columbia, TN 38401 2018-07-02
1407343148 Tammy Lynn James Nurse Practitioner 6011 Trotwood Ave Ste D, Columbia, TN 38401 2018-04-18
1053838276 Tiffany Huskey Audiologist-Hearing Aid Fitter 1202 S James Campbell Blvd, Suite 15, Columbia, TN 38401 2017-08-28
1942726963 Northland Hearing Center, Inc. Hearing Aid Equipment 1202 South James Campbell Blvd, Suite 15, Columbia, TN 38401 2017-08-22
Find all providers in zip 38401

Taxonomy Information

Taxonomy Code 2086S0122X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Plastic and Reconstructive Surgery

Taxonomy Definition

A surgeon who specializes in plastic and reconstructive surgery.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1407472251 Paulina Bao Tran Le Surgery Prisma Health Medical Group Plastic Surgery, 2 Medical Park, Ste 302, Columbia, SC 29203 2020-06-17
1285126060 Ameya Atul Chumble Surgery 1 Hospital Dr Rm M349, Columbia, MO 65212-1000 2018-06-06
1689103053 Angela Hulsey Surgery 1 Hospital Dr # M349, Columbia, MO 65212-1000 2017-06-08
1265813950 Brandon Lambiris Surgery 1 Hospital Dr # Dc064.00, Division of Plastic Surgery, Columbia, MO 65212-1000 2015-06-18
1366496515 Matthew J Concannon Surgery 3115 Falling Leaf Ct, Columbia, MO 65201-3579 2006-05-20
1053381202 Gary A Vela Surgery 8600 Snowden River Pkwy, Suite 308, Columbia, MD 21045-1982 2006-01-23
1447876057 Brooke Elizabeth Porter Surgery 1 Hospital Dr Rm M349, Columbia, MO 65212-1000 2020-06-19
1306407309 Sarah Elizabeth Langsdon Surgery 1 Hospital Dr Rm M349, Columbia, MO 65212-1000 2019-06-21
1184284606 Benjamin Jay Kirby Surgery 1 Hospital Dr Rm M349, Columbia, MO 65212-1000 2019-06-17
1265926851 Carlos Ranjan Martinez Surgery Surgery Clinic, 1801 Sunset Drive, Columbia, SC 29203 2018-06-18
Find all providers in COLUMBIA

Competitor

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City COLUMBIA
Zip Code 38401

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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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