# JOHN P TUTTLE JR MD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clinic for Urologic Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639394208
- **Authorized official:** DR. JOHN P TUTTLE JR. MD (PRESIDENT)
- **Authorized official phone:** (859) 263-1300

## Contact information

- **Practice address:** 160 NORTH EAGLE CREEK, STE 301, LEXINGTON, KY 40509
- **Practice address phone:** (859) 263-1300
- **Practice address fax:** (859) 263-4395
- **Mailing address:** 160 NORTH EAGLE CREEK, STE 301, LEXINGTON, KY 40509
- **Mailing address phone:** (859) 263-1300
- **Mailing address fax:** (859) 263-4395

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 19237 | KY | Yes |

## Other

- **Enumeration date:** 04/17/2007
- **Last updated:** 12/27/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 64192370 | — | KY |