Provider Demographics
NPI:1164489662
Name:TUTTLE, RALPH EDWIN (DO)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:EDWIN
Last Name:TUTTLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:MR
Other - First Name:RALPH
Other - Middle Name:EDWIN
Other - Last Name:TUTTLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:100 GREY MOSS CT
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-3815
Mailing Address - Country:US
Mailing Address - Phone:360-979-6202
Mailing Address - Fax:
Practice Address - Street 1:NAVAL MEDICAL CENTER CAMP LEJEUNE
Practice Address - Street 2:100 BREWSTER BLVD
Practice Address - City:CAMP LEJEUNE
Practice Address - State:NC
Practice Address - Zip Code:28547
Practice Address - Country:US
Practice Address - Phone:910-450-4145
Practice Address - Fax:910-450-3762
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002839A2084P2900X, 2084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine