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Contact Information

OTIS E TILLMAN JR, MD
1942 NORTH AVENUE
COLUMBUS, GA31901
 Phone: 706-596-1245
 Fax: 706-576-4245
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for OTIS E TILLMAN JR · (Male)

NPI Number 1962597385
Status Active
Credentials MD
Entity Individual
Enumeration date 10/03/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 040576
  • GA Medicaid 00669127C
  • AL Other 60027547 BCBS OF ALABAMA
  • GA Other 224251 BCBS OF GEORGIA
Hospital affiliation(s)
  • HUGHSTON HOSPITAL - (Acute Care)
    100 FRIST COURT
    COLUMBUS, GA 31909
  • MEDICAL CENTER THE - (Acute Care)
    710 CENTER ST BOX 951
    COLUMBUS, GA 31901
  • ST FRANCIS HOSPITAL INC - (Acute Care)
    2122 MANCHESTER EXPRESSWAY
    COLUMBUS, GA 31995
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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