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Contact Information

JASON B TILLEY, DO
2900 S TELEPHONE RD STE 250
MOORE, OK73160
 Phone: 814-232-1477
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for JASON B TILLEY · (Male)

NPI # 1609162205
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 06/22/2011
Last updated 07/26/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • OK License # 6304
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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