Individual
SCOTT L TARLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7950 W JEFFERSON BLVD, SUITE 2121, FORT WAYNE, IN 46804-4140
(260) 407-8000
(260) 407-8004
Mailing address
250 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0104896
IN
207Q00000X
Family Medicine Physician
Primary
01048968A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200147130
—
IN
Enumeration date
07/16/2006
Last updated
10/07/2020
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