Provider Demographics
NPI:1700163045
Name:SEAN STILTNER, D.O.,LLC
Entity Type:Organization
Organization Name:SEAN STILTNER, D.O.,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:STILTNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:740-352-7733
Mailing Address - Street 1:715 W EMMITT AVE
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:OH
Mailing Address - Zip Code:45690-1015
Mailing Address - Country:US
Mailing Address - Phone:740-947-8000
Mailing Address - Fax:740-947-8008
Practice Address - Street 1:121 FAIRWAY AVE
Practice Address - Street 2:
Practice Address - City:PIKETON
Practice Address - State:OH
Practice Address - Zip Code:45661-9123
Practice Address - Country:US
Practice Address - Phone:740-352-7733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care