| Laura Tilton Md Llc | |
|
1900 Sunrise Dr Saint Peter MN 56082-5376 | |
| (702) 453-3799 | |
| (702) 453-5741 |
| Full Name | Laura Tilton Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1900 Sunrise Dr, Saint Peter, Minnesota |
| Authorized Official Name and Position | Laura Tilton (SOLE OWNER) |
| Authorized Official Contact | 6128171894 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laura Tilton Md Llc Po Box 2312 Mankato MN 56002-2312 Ph: (702) 453-3799 | Laura Tilton Md Llc 1900 Sunrise Dr Saint Peter MN 56082-5376 Ph: (702) 453-3799 |
| NPI Number | 1053863555 |
|---|---|
| Provider Enumeration Date | 10/31/2016 |
| Last Update Date | 10/31/2016 |
| Medicare PECOS PAC ID | 8628357001 |
|---|---|
| Medicare Enrollment ID | O20161108002375 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053863555 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 48779 (Minnesota) | Primary |
| Provider Name | Laura E Tilton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710164488 PECOS PAC ID: 3476611088 Enrollment ID: I20081027000550 |
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