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

Jason Keith Fultz, DO

Individual provider Family Medicine Physician · NPI 1164083093

Jason Keith Fultz, DO is a Family Practice in Madison, Alabama. Qualified in 2019, 7 years ago. Practices with Crestwood Physician Services, LLC, a 38-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
7
Licensed in
MO
In the registry since
2019
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

1650 Slaughter Rd Ste A
Madison, AL 35758-8610
Phone: (256) 325-3646
Fax: (256) 325-3647
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 551 E Southampton Dr, Columbia, MO 65201-4236 — (573) 884-7733

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 2019022592 (MO)

Record details

NPI number1164083093
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 21, 2019
Last updated in NPPESAugust 1, 2022
Certification dateAugust 1, 2022
Mailing address551 E Southampton Dr, Columbia, MO 65201-4236

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Crestwood Physician Services, Llc — 38 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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