Dr Douglas L Fulk, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Carbondale, Illinois. He went to Saint Louis University School Of Medicine and graduated in 1993 and has 31 years of diverse experience with area of expertise as Diagnostic Radiology. His current practice location is
1200 Cedar Ct, Carbondale, Illinois. You can reach out to his office (for appointments etc.) via phone at
(618) 529-8500.
Dr Douglas L Fulk is licensed to practice in Illinois (license number 036091745) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1992780050.
Physician's Profile
| Full Name | Dr Douglas L Fulk |
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| Gender | Male |
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| Speciality | Diagnostic Radiology |
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| Experience | 31 Years |
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| Location | 1200 Cedar Ct, Carbondale, Illinois |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Douglas L Fulk attended and graduated from Saint Louis University School Of Medicine in 1993
NPI Data:
- NPI Number: 1992780050
- Provider Enumeration Date: 12/13/2005
- Last Update Date: 03/09/2011
Medicare PECOS Information:
- PECOS PAC ID: 5092704700
- Enrollment ID: I20040508000140
Medical Identifiers
Medical identifiers for Dr Douglas L Fulk such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1992780050 | NPI | - | NPPES |
| 036091745-1 | Medicaid | IL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2085R0202X | Radiology - Diagnostic Radiology | 036091745 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Douglas L Fulk allows following entities to bill medicare on his behalf.
| Entity Name | Radiologic Interpretations Of Southern Illinois Ltd |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1730218652
PECOS PAC ID: 9335249606
Enrollment ID: O20070716000562 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Douglas L Fulk is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Douglas L Fulk, MD
Po Box 969, Attn: Debbie Strauss,
Carbondale, IL 62903-0969
Ph: (314) 821-8055 | Dr Douglas L Fulk, MD
1200 Cedar Ct,
Carbondale, IL 62901-5334
Ph: (618) 529-8500 |
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