| William L. Fulliton | |
|
100 N Main St Suite 2315 Memphis TN 38103-5011 | |
| (901) 527-2248 | |
| Not Available |
| Full Name | William L. Fulliton |
|---|---|
| Speciality | Psychologist |
| Location | 100 N Main St, Memphis, Tennessee |
| Authorized Official Name and Position | William Leslie Fulliton (PRESIDENT/CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 9015272248 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| William L. Fulliton 100 N Main St Suite 2315 Memphis TN 38103-5011 Ph: (901) 527-2248 | William L. Fulliton 100 N Main St Suite 2315 Memphis TN 38103-5011 Ph: (901) 527-2248 |
| NPI Number | 1154758746 |
|---|---|
| Provider Enumeration Date | 09/27/2013 |
| Last Update Date | 10/29/2013 |
| Medicare PECOS PAC ID | 4284869751 |
|---|---|
| Medicare Enrollment ID | O20131109000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154758746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | P1531 (Tennessee) | Primary |
| Provider Name | William Leslie Fulliton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578997615 PECOS PAC ID: 5193950665 Enrollment ID: I20131109000207 |
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