Tillman Medical Group Pa

NPI 1043260615 - Specialist - 174400000X

NPI Details
NPI 1043260615
Enumeration Date 05/12/2006
Last Updated 06/04/2013
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name TANA L TANA
Position ACCOUNTS MANAGER
Phone (318) 336-2216
Fax
Practice Location
107 FRONT ST
VIDALIA LA, 71373-2836, US
Phone (318) 336-2216
Fax
Business Location
107 FRONT ST
VIDALIA LA, 71373-2836, US
Phone (318) 336-2216
Fax
Toxanomy
Taxonomy Code 174400000X
License State Louisiana
License Number 5D595
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According to our database, Tillman Medical Group Pa NPI is 1043260615, taxonomy code is 174400000X and license number is 5D595, license state is located at Louisiana. Tillman Medical Group Pa physically located at 107 Front St, Vidalia LA, 71373-2836. NPI Number 1033115704 has the healthcare provider type.

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1043260615 NPI number is provided on an as is basis without warranty of any kind. 1043260615 is maintained by the National Plan & Provider Enumeration System. The contents of Tillman Medical Group Pa are for informational purposes only.