TILLMAN MEDICAL GROUP PA
NPI 1043260615
Specialist in Vidalia, LA

Active since May 12, 2006
107 FRONT ST, VIDALIA, LA 71373(318) 336-2216 Get Directions Write a Review

NPPES record last updated: June 4, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Tillman Medical Group Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TILLMAN MEDICAL GROUP PA (NPI 1043260615) is a healthcare organization registered as a specialist in Vidalia, Louisiana and active in the NPI registry since May 2006. The organization lists Tana L Archer, Accounts Manager, as its authorized official.

NPPES Registry Identity

NPI1043260615
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameTILLMAN MEDICAL GROUP PA
Location Address107 FRONT STVidalia, LA 71373-2836
Mailing Address107 Front StVidalia, LA 71373-2836 · (318) 336-2216
Organization SubpartNo
Authorized OfficialTana L ArcherAccounts Manager · (318) 336-2216
Enumeration DateMay 12, 2006
Last NPPES UpdateJune 4, 2013
NPI 1043260615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License Licensed in LA · 5D595
Definition

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.

107 FRONT ST, Vidalia, LA 71373

Other Identifiers 1

Medicare ID-Type Unspecified5D595LA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
107 FRONT ST, SUITE 2109
VIDALIA, LA 71373
Otolaryngology
107 FRONT ST, SUITE 240
VIDALIA, LA 71373
Clinic/Center (Radiology)
107 FRONT ST
VIDALIA, LA 71373
Clinic/Center (Ambulatory Surgical)
107 FRONT ST, STE.1100
VIDALIA, LA 71373
Internal Medicine (Gastroenterology)
107 FRONT ST, SUITE 2126
VIDALIA, LA 71373
Nurse Practitioner (Family)
107 FRONT ST
VIDALIA, LA 71373
Social Worker (Clinical)
107 FRONT ST, STE 2134
VIDALIA, LA 71373
Internal Medicine (Pulmonary Disease)
107 FRONT ST
VIDALIA, LA 71373

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043260615, enumerated as an "organization" on May 12, 2006.

The provider is located at 107 FRONT ST VIDALIA, LA 71373 and the phone number is (318) 336-2216.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.