National Provider Identifier Database

TILLMAN MEDICAL GROUP PA
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

TILLMAN MEDICAL GROUP PA
800 AUDUBON DR
JONESVILLE, LA71343
Phone: 318-339-4112
Fax: 318-339-6388
Website:
Specialty Taxonomy Code
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for TILLMAN MEDICAL GROUP PA

NPI Number 1922124312
Legal business name
LBN
TILLMAN MEDICAL GROUP PA
Authorized official SUSAN DAVIS - (ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 03/21/2007
Last updated 07/08/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • LA License #: 07480R
  • LA Medicaid: 1447498

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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