Robert W Fulton, P.T.
Individual provider Active NPI Physical Therapist · Hartford, WI
NPI 1164636619 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1164636619
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1209-024 (WI)
- Practice address
- 1640 East Sumner Street
Hartford, WI 53027 - Phone
- (262) 670-4314
- Fax
- (262) 670-4301
- NPI assigned
- May 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1209-024 | WI | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1209-024 | WI | Yes |
Addresses
Primary practice location
1640 East Sumner Street
Hartford, WI 53027
Mailing address
N59W26370 Indian Head Dr
Sussex, WI 53089-4008
Phone (262) 538-0894
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36103300 | Medicaid | WI |
Other providers in Hartford, WI
- Pamela Sue Feucht
- Iesha Marie Floyd-Barkley
- Janet Lynn Fredericks
- Froedtert &the Medical College of Wisconsin Community Physicians, Inc.
- Kathryn A Frohmader
- Michelle Lynn Gaffney
- Christine Garms
- Christopher M Garvey
- Suzanne Gehl
- Antony V George
All providers in Hartford, WI · Physical Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.