Provider Demographics
NPI:1376276758
Name:DR. RODNEY A. TITTLE
Entity Type:Organization
Organization Name:DR. RODNEY A. TITTLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:TITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-978-5423
Mailing Address - Street 1:102 PHYSICIANS DR STE C
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-2149
Mailing Address - Country:US
Mailing Address - Phone:256-978-5423
Mailing Address - Fax:256-320-5501
Practice Address - Street 1:102 PHYSICIANS DR
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2148
Practice Address - Country:US
Practice Address - Phone:256-978-5423
Practice Address - Fax:256-320-5501
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. RODNEY A. TITTLE D.M.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental