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Individual

MIKEL TIHISTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8372
Mailing address
PO BOX 148, HARTFORD, KY 42347-0148
(270) 504-1910
(270) 298-3824

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
59432
KY

Other

Enumeration date
05/22/2019
Last updated
06/07/2025
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