MEDICARE: DR. BARBARA ELAINE TILBEN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	3992	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0410400	OTHER	AZ	CIGNA
2	5955103	OTHER	AZ	AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	41956	OTHER	AZ	UNIVERSAL HEALTHCARE
5	P01230458	OTHER	AZ	RAILROAD MCR

General Provider Information

NPI Number	:	1093710261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA ELAINE TILBEN DO

Provider Business Mailing Address
First Line	:	21300 N JOHN WAYNE PKWY STE 115
Second Line	:
City	:	MARICOPA
State	:	AZ
Zip	:	85139-8978
Country	:	US
Telephone Number	:	520-426-3424
Fax Number	:	520-568-9560

Provider Business Practice Location Address
First Line	:	21300 N JOHN WAYNE PKWY STE 115
Second Line	:
City	:	MARICOPA
State	:	AZ
Zip	:	85139-8978
Country	:	US
Telephone Number	:	520-426-3424
Fax Number	:	520-568-9560

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	02/17/2015

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