# TILLOTSON PRIMARY CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336431642
- **Authorized official:** TANDARA M JARBOE (MANAGER)
- **Authorized official phone:** (765) 716-0693

## Contact information

- **Practice address:** 100 N TILLOTSON AVE, MUNCIE, IN 47304-3987
- **Practice address phone:** (765) 281-9497
- **Practice address fax:** (765) 281-8850
- **Mailing address:** 100 N TILLOTSON AVE, MUNCIE, IN 47304-3987
- **Mailing address phone:** (765) 281-9497
- **Mailing address fax:** (765) 281-8850

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/04/2011
- **Last updated:** 05/04/2011