Fullin, Kevin J

Fullin, Kevin J is an individual health care provider with primary practice located at 6308 8Th Ave Suite 3060, Kenosha WI 53143-5082. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Fullin, Kevin J can be contacted via phone (262) 656-3650.

Contact Information

Primary practice address
6308 8Th Ave Suite 3060 Kenosha WI 53143-5082
Phone: (262) 656-3650
Fax: (262) 656-3671
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 27973 Wisconsin
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 27973 Wisconsin

Profile Details

NPI number 1346224532
LBN Legal business name Fullin, Kevin J
Credentials MD FACC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2005
Last updated Aug 7th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346224532 NPPES
Wisconsin MEDICAID 30742900
Wisconsin MEDICAID 1346224532

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