Phillip Tyler Fuller, MD in Ada, OK

Phillip Tyler Fuller, MD is a medicare enrolled "Urology" physician in Ada, Oklahoma. He went to University Of Oklahoma College Of Medicine and graduated in 2009 and has 15 years of diverse experience with area of expertise as Urology. He is a member of the group practice Chickasaw Nation Division Of Health Chickasaw Nation Medical Center and his current practice location is 1414 Arlington Street, Suite 2300, Ada, Oklahoma. You can reach out to his office (for appointments etc.) via phone at (580) 332-0112.

Phillip Tyler Fuller is licensed to practice in Oklahoma (license number 30483) 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 1871720300.

Contact Information

	Phillip Tyler Fuller, MD
	1414 Arlington Street, Suite 2300, Ada, OK 74820
	(580) 332-0112
	(580) 332-1005

Map and Direction

Physician's Profile

Full Name	Phillip Tyler Fuller
Gender	Male
Speciality	Urology
Experience	15 Years
Location	1414 Arlington Street, Ada, Oklahoma
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Phillip Tyler Fuller attended and graduated from University Of Oklahoma College Of Medicine in 2009

NPI Data:

NPI Number: 1871720300
Provider Enumeration Date: 06/11/2009
Last Update Date: 06/25/2014

Medicare PECOS Information:

PECOS PAC ID: 9335373802
Enrollment ID: I20141201001941

Medical Identifiers

Medical identifiers for Phillip Tyler Fuller such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1871720300	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208800000X	Urology	30483 (Oklahoma)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Chickasaw Nation Medical Center	Ada, OK	Hospital
Integris Southwest Medical Center	Oklahoma city, OK	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Chickasaw Nation Division Of Health Chickasaw Nation Medical Center	8426957523	219

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. Phillip Tyler Fuller allows following entities to bill medicare on his behalf.

Entity Name	Chickasaw Nation Division Of Health Chickasaw Nation Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1255364923 PECOS PAC ID: 8426957523 Enrollment ID: O20040108000364

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. Phillip Tyler Fuller 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
Phillip Tyler Fuller, MD 1414 Arlington Street, Suite 2300, Ada, OK 74820 Ph: (580) 332-0112	Phillip Tyler Fuller, MD 1414 Arlington Street, Suite 2300, Ada, OK 74820 Ph: (580) 332-0112

Phillip Tyler Fuller, MD - Medicare Urology in Ada, OK