| Tiltonsville Clinic, Llc | |
|
342 Jefferson St Tiltonsville OH 43963-1058 | |
| (740) 859-2121 | |
| (740) 859-2443 |
| Full Name | Tiltonsville Clinic, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 342 Jefferson St, Tiltonsville, Ohio |
| Authorized Official Name and Position | Douglas Scott Trubiano (DIRECTOR OWNER) |
| Authorized Official Contact | 7408592121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tiltonsville Clinic, Llc 342 Jefferson St Tiltonsville OH 43963-1058 Ph: (740) 859-2121 | Tiltonsville Clinic, Llc 342 Jefferson St Tiltonsville OH 43963-1058 Ph: (740) 859-2121 |
| NPI Number | 1063412450 |
|---|---|
| Provider Enumeration Date | 07/28/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063412450 | NPI | - | NPPES |
| 000000301650 | Other | ANTHEM PIN# | |
| HEALTH PLAN OF UPPER | Other | OH | HMO PIN# |
| 7576355 | Other | AETNA PIN# | |
| 236049386002 | Other | OH | MED. MUT PIN# |
| 224201 | Other | HEALTH AMERICA/ASSURANCE | |
| 205446 | Other | ADVANTRA PIN# | |
| 2346429 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 34007831T (Ohio) | Primary |
Tiltonsville Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 342 Jefferson St, Tiltonsville, OH 43963 Phone: 740-859-2121 |