E A Tillman is a Dentist in Crestview, Florida. E A Tillman practices all healthcare services and medical treatments related to Dentist. The NPI Number for E A Tillman is 1649487398. The last update date is 2007-07-08.
E A Tillman's current location address is 285 N Ferdon Blvd, Crestview, Florida. You can contact this provider via phone number 8506822408. The mailing address for E A Tillman is 285 N Ferdon Blvd, Crestview, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | E A Tillman |
|---|---|
| Address | 285 N Ferdon Blvd, Crestview, Florida |
| Phone Number | 8506822408 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1649487398 |
|---|---|
| Provider Enumeration Date | 2007-05-16 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 285 N Ferdon Blvd |
|---|---|
| City | Crestview |
| State | Florida (FL) |
| Post Code | 325362751 |
| Phone Number | 8506822408 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 9341 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 977588 | FL | UNITED CONCORDIA |
Post Comment/ Review Below
What is the unique provider identifier assigned to E A Tillman?
The E A Tillman has been issued the NPI (National Provider Identifier) 1649487398 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Can you provide the E A Tillman's physical address?
The E A Tillman is physically located at 285 N Ferdon Blvd, in the city of Crestview, FL, with the postal code 325362751.
What is the E A Tillman's specialty and taxonomy code?
The E A Tillman's specialty is Dentist, and the corresponding taxonomy code is 122300000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1649487398 to E A Tillman?
The Centers for Medicare & Medicaid Services originally issued the 1649487398 to E A Tillman on 2007-05-16.
As of what date were the E A Tillman's details last updated?
The information pertaining to the E A Tillman, including its address, specialty, and other details, was most recently updated on 2007-07-08.
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