Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Blake Fulks, MD

Individual provider Family Medicine Physician · NPI 1528440534

Blake Fulks, MD is a Family Practice in Springfield, Missouri. Graduated from University of Arkansas College of Medicine in 2015, 11 years ago. Practices with Skaggs Community Hospital Association, a 212-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
11
Trained at
University of Arkansas College of Medicine
Licensed in
MO
In the registry since
2015
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1423 N Jefferson Ave # B100
Springfield, MO 65802-1917
Phone: (417) 269-8817
Fax: (417) 269-8744
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 2015020398 (MO)

Record details

NPI number1528440534
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 25, 2015
Last updated in NPPESJune 25, 2015
Mailing address1423 N Jefferson Ave # B100, Springfield, MO 65802-1917

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Graduated 2015 (11 years in practice)
Group practice Skaggs Community Hospital Association — 212 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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