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Organization

THERON C TILGNER D O LLC

Active
Other names
ORTHOPEDIC INNOVATIONS
Organization subpart
No

Provider details

NPI number
Authorized official
THERON C TILGNER D.O. (PRESIDENT)
(928) 854-3333
Entity
Organization

Contact information

Practice address
387 LAKE HAVASU AVE S STE 101, LAKE HAVASU CITY, AZ 86403-9306
(928) 854-3333
(928) 854-3335
Mailing address
387 LAKE HAVASU AVE S STE 101, LAKE HAVASU CITY, AZ 86403-9306
(928) 854-3333
(928) 854-3335

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
999328
AZ
Enumeration date
03/14/2006
Last updated
01/14/2025
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