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

Tracie Fullove, MD

Individual provider Family Medicine Physician · NPI 1962865659

Tracie Fullove, MD is a Family Practice in Fayetteville, Arkansas. Graduated from University of Mississippi School of Medicine in 2016, 10 years ago. Practices with Mercy Northwest Arkansas Ambulatory Services, LLC, a 50-clinician group and accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
10
Trained at
University of Mississippi School of Medicine
Licensed in
AR
In the registry since
2016
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

3162 W Martin Luther King Blvd Ste 13-14
Fayetteville, AR 72704-7679
Phone: (479) 935-4834
Fax: (479) 249-9879
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence E-11276 (AR)

Record details

NPI number1962865659
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 31, 2016
Last updated in NPPESJune 19, 2019
Mailing address607 Hampton Cir Apt G, Jackson, MS 39211-2334

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice Mercy Northwest Arkansas Ambulatory Services, Llc — 50 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fayetteville