Provider Demographics
NPI:1508100645
Name:TUTHILL, NEIL GARY (RPH)
Entity Type:Individual
Prefix:MR
First Name:NEIL
Middle Name:GARY
Last Name:TUTHILL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4061 OLD PESHTIGO RD
Mailing Address - Street 2:PO BOX 18
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143-3887
Mailing Address - Country:US
Mailing Address - Phone:715-732-8040
Mailing Address - Fax:715-732-8038
Practice Address - Street 1:4061 OLD PESHTIGO RD
Practice Address - Street 2:
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-3887
Practice Address - Country:US
Practice Address - Phone:715-732-8040
Practice Address - Fax:715-732-8038
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11966-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist