Provider Demographics
NPI:1033327986
Name:TUTTLE LLC
Entity type:Organization
Organization Name:TUTTLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TUTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-824-8787
Mailing Address - Street 1:PO BOX 1289
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47202-1289
Mailing Address - Country:US
Mailing Address - Phone:812-342-3859
Mailing Address - Fax:812-342-4760
Practice Address - Street 1:3550 W TWO MILE HOUSE RD
Practice Address - Street 2:SUITE C
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-9242
Practice Address - Country:US
Practice Address - Phone:812-342-3859
Practice Address - Fax:812-342-4760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01057718A208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INH86178Medicare UPIN
IN252400Medicare PIN