Provider Demographics
NPI:1073895009
Name:TUTTLE, CYRUS LINDEN
Entity Type:Individual
Prefix:DR
First Name:CYRUS
Middle Name:LINDEN
Last Name:TUTTLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4951 ROE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROELAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66205-1109
Mailing Address - Country:US
Mailing Address - Phone:913-236-6978
Mailing Address - Fax:913-236-5392
Practice Address - Street 1:4951 ROE BLVD
Practice Address - Street 2:
Practice Address - City:ROELAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66205-1109
Practice Address - Country:US
Practice Address - Phone:913-236-6978
Practice Address - Fax:913-236-5392
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-13893183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist