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Contact Information

TILLMAN MEDICAL GROUP PA
800 AUDUBON DR
JONESVILLE, LA71343
 Phone: 318-339-4112
 Fax: 318-339-6388
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for TILLMAN MEDICAL GROUP PA · (Female)

NPI # 1922124312
Status Active
Credentials
Entity Individual
Enumeration date 03/21/2007
Last updated 07/08/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • LA License # 07480R
  • LA Medicaid 1447498
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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