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1871720300
PHILLIP TYLER FULLER
ADA, OK
NPI
1871720300
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208800000X Urology
(Licence: OK 30483)
Enumeration Date
2009-06-11
Last Update Date
2014-06-25
Business Address
PHILLIP TYLER FULLER M.D.
1414 ARLINGTON STREET SUITE 2300
ADA, OK 74820
Phone number: 580-332-0112
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Mailing Address
PHILLIP TYLER FULLER M.D.
1414 ARLINGTON STREET SUITE 2300
ADA, OK 74820
Phone number: 580-332-0112
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