Individual
TIA M ALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
150 FRANKFORT RD STE 101, SHELBYVILLE, KY 40065-7401
(502) 647-5468
(502) 647-7134
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 272-5395
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
46839
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2011
Last updated
03/15/2021
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