Provider Demographics
NPI:1033722301
Name:NOBLE HEALTH FULTON INC
Entity Type:Organization
Organization Name:NOBLE HEALTH FULTON INC
Other - Org Name:PROFESSIONAL GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-642-3376
Mailing Address - Street 1:10 S HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MO
Mailing Address - Zip Code:65251-2510
Mailing Address - Country:US
Mailing Address - Phone:573-642-3776
Mailing Address - Fax:573-592-6690
Practice Address - Street 1:10 S HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251-2510
Practice Address - Country:US
Practice Address - Phone:573-642-3776
Practice Address - Fax:573-592-6690
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOBLE HEALTH FULTON INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-26
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty