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Individual

DR. FRED THOMAS TUTTLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4106 MASON WOODS LN, OWENSBORO, KY 42303-7552
(270) 993-3999
Mailing address
4106 MASON WOODS LN, OWENSBORO, KY 42303-7552
(270) 993-3999

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19911
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000206950
ANTHEM BLUE CROSS
01
010619500
BLACK LUNG
01
080177443
RAILROAD MEDICARE
01
1001684
METRACOMP
01
1155576
PASSPORT
KY
01
1195470
CHA HEALTH
01
2438914000
PASSPORT ADVANTAGE
KY
01
34346
UNITED HEALTHCARE
01
40582791500
CAREWORKS
01
443632
AETNA
01
610901982
BLUEGRASS FAMILY HEALTH
01
6109019820030
CIGNA
01
610901982E
HUMANA
05
64199110
KY
01
65917551
KENPAC
KY
01
P00020977
RAILROAD RETIREMENT
Enumeration date
01/03/2007
Last updated
07/02/2009
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