DR. OTIS EDWARD TILLMAN JR. (NPI# 1962597385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962597385 |
| Entity Type | Individual |
| Full Name | DR. OTIS EDWARD TILLMAN JR. |
| Credential | M.D. |
| Practice Address |
1942 North Avenue Columbus GA 31901 |
| Practice Telephone | 7065961245 |
| Practice Fax Number | 7065764245 |
| Mailing Telephone | 7065961245 |
| Mailing Fax Number | 7065764245 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 040576 | GA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00669127C | 05 | |
| GA | BCBS OF GEORGIA | 224251 | 01 |
| AL | BCBS OF ALABAMA | 60027547 | 01 |
| Street Address |
1942 NORTH AVENUE |
| City | COLUMBUS |
| State | GA |
| Zip Code | 31901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841383593 | William Robert Lahouse | Specialist | 1942 North Avenue, Columbus, GA 31901 | 2006-10-02 |
| 1831285683 | Stephen Donald Raborn | Specialist | 1942 North Avenue, Columbus, GA 31901 | 2006-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790396984 | Chisholm Trail Urgent Care Pllc | Emergency Medicine | 11 Tsys Way, Columbus, GA 31901 | 2020-08-12 |
| 1770040099 | Columbus Ga Homecare, LLC | In Home Supportive Care | 1501 13th Street., Suite G, Columbus, GA 31901 | 2019-02-22 |
| 1750868782 | Health Matters, Inc. | Clinic/Center | 1124 13th St, Columbus, GA 31901 | 2018-07-23 |
| 1447754197 | Charles Chacha Maroa Babere | Student in an Organized Health Care Education/Training Program | Columbus Regional Health, Midtown Medical Center, 1900 10th Avenue, Suit 100, Columbus, GA 31901 | 2018-03-19 |
| 1861912867 | Demetria Laprel Mcgruder | Community Health Worker | 1230 2nd Ave., Columbus, GA 31901 | 2017-06-21 |
| 1679932016 | Crystal Gayle Passmore | Counselor | 233 12th St Ste 334, Columbus, GA 31901 | 2016-02-13 |
| 1700256344 | Kendra Ward | Community Health Worker | 1230 2nd Avenue, Columbus, GA 31901 | 2015-09-25 |
| 1437556701 | Wendy Denise Thomas | Adult Companion | 1501 13th Street Suite F, Columbus, GA 31901 | 2014-12-02 |
| 1134523996 | Danielle Elaine Berry | General Practice | Tree of Life Healthcare, 1968 North Avenue, Columbus, GA 31901 | 2014-10-22 |
| 1710239330 | Kati Michelle Turner | Pharmacist | 1800 10th Avenue, Columbus, GA 31901 | 2012-10-05 |
| Find all providers in zip 31901 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | 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. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891327755 | Dejuan Julius Nelson | Specialist | 4937 Mcallister Ave, Columbus, OH 43227-1447 | 2020-02-09 |
| 1306481676 | Big Heads Barber Salon | Specialist | 6161 Busch Blvd Ste 56, Columbus, OH 43229-2548 | 2019-11-11 |
| 1538723945 | Nakia Frazier | Specialist | 4913 Festival St, Columbus, GA 31907-6065 | 2019-05-01 |
| 1033772868 | Kimberly Gore Salon Inc | Specialist | 2534 Wynnton Rd Ste B, Columbus, GA 31906-2180 | 2019-04-17 |
| 1184108375 | Crystal Denise Allen | Specialist | 3029 Cleveland Ave, Columbus, OH 43224-4421 | 2018-09-24 |
| 1770074445 | Robert Tavani | Specialist | 1203 E Broad St, Columbus, OH 43205-1404 | 2018-05-29 |
| 1689191991 | Columbus Tutoring Services, LLC | Specialist | 2700 E Main St Ste 211, Columbus, OH 43209-2536 | 2017-08-28 |
| 1265985352 | Tim Jones | Specialist | 1527 Eastmeadow Pl, Columbus, OH 43235-7535 | 2016-07-26 |
| 1790148849 | Gabriel Woon | Specialist | 913 25th St., Columbus, IN 47201 | 2016-04-05 |
| 1487059606 | Wilbert Herschel Turner IIi | Specialist | 1160 Steelwood Rd, Columbus, OH 43212-1356 | 2014-10-30 |
| Find all providers in COLUMBUS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.