Individual
CLIFTON PAUL TITCOMB JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4514 SCOTIA DR, FORT WAYNE, IN 46814-9781
(260) 625-6869
Mailing address
4514 SCOTIA DR, FORT WAYNE, IN 46814-9781
(260) 625-6869
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01040200A
IN
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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