Provider Demographics
NPI:1326426263
Name:TILTON, RICHARD KYLE (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:KYLE
Last Name:TILTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:32 STRAWBERRY HILL CT STE 4
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2594
Mailing Address - Country:US
Mailing Address - Phone:203-353-0000
Mailing Address - Fax:203-357-8109
Practice Address - Street 1:32 STRAWBERRY HILL CT STE 4
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2594
Practice Address - Country:US
Practice Address - Phone:203-353-0000
Practice Address - Fax:203-357-8109
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-10205207Y00000X
CT64391207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology