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General NPI Number Information
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NPI Number | 1194962365
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Entity Type | Organization
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Legal Business Name | PHILLIP TUTNAUER DPM
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Dates
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Enumeration Date | 01/09/2009
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 2175 STATE RD 4
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City | PINON
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State | AZ
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Zip | 86510
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Country | US
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Telephone | 928-725-9500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10
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City | PINON
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State | AZ
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Zip | 86510-0010
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Country | US
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Telephone | 928-725-9600
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. PHILLIP TUTNAUER
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Credential | DPM
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Telephone | 928-725-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | MD01901
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License Number State | NJ
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