Provider Demographics
NPI:1093710261
Name:TILBEN, BARBARA ELAINE (DO)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ELAINE
Last Name:TILBEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21300 N JOHN WAYNE PKWY STE 115
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85139-8978
Mailing Address - Country:US
Mailing Address - Phone:520-426-3424
Mailing Address - Fax:520-568-9560
Practice Address - Street 1:21300 N JOHN WAYNE PKWY STE 115
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85139-8978
Practice Address - Country:US
Practice Address - Phone:520-426-3424
Practice Address - Fax:520-568-9560
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3992207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0410400OtherCIGNA
AZ5955103OtherAETNA
AZ921347Medicaid
AZ41956OtherUNIVERSAL HEALTHCARE
AZP01230458OtherRAILROAD MCR
AZ5955103OtherAETNA
AZP01230458OtherRAILROAD MCR
AZZ160553Medicare PIN
AZ0410400OtherCIGNA