Elbert S Tillerson (NPI# 1003872714, PAC ID# 8527089911) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is HOSPITALIST.
| Nation Provider ID (NPI) | 1003872714 |
| PAC ID by PECOS | 8527089911 |
| Professional Enrollment ID | I20120326000015 |
| Full Name | Elbert S Tillerson |
| Organization Legal Name | LANDMARK HOSPITAL OF COLUMBIA, LLC |
| Address |
604 Old 63 Columbia MO 65201-6308 |
| Phone Number | 5734996632 |
| Gender | M |
| Credential | MD |
| Medical School | MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE |
| Graduation Year | 2001 |
| Primary Specialty | HOSPITALIST |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 2062568025 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260047 | CAPITAL REGION MEDICAL CENTER |
| 260141 | UNIVERSITY OF MISSOURI HOSPITAL & CLINICS |
| 260068 | BOONE HOSPITAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 604 Old 63, Columbia, MO 65201-6308 | 5734996632 | LANDMARK HOSPITAL OF COLUMBIA, LLC |
| 1125 Madison St, Jefferson City, MO 65101-5227 | 5736325000 | HOSPITAL MEDICINE SERVICES OF TENNESSEE PC |
| 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 5736325000 | HOSPITAL MEDICINE SERVICES OF TENNESSEE PC |
| Organization Legal Name | LANDMARK HOSPITAL OF COLUMBIA, LLC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ricardo A Hernandez | Critical Care (intensivists) | Landmark Hospital of Columbia, LLC | 604 Old 63, Columbia, MO 65201-6308 |
| Delali K Buatsi | Hospitalist | Landmark Hospital of Columbia, LLC | 604 Old 63, Columbia, MO 65201-6308 |
| Tareq M Abu Salah | Pulmonary Disease | Landmark Hospital of Columbia, LLC | 604 Old 63, Columbia, MO 65201-6308 |
| Norvin E Thomas | Pulmonary Disease | Landmark Hospital of Columbia, LLC | 604 Old 63, Columbia, MO 65201-6308 |
| Julie M Lewis | Certified Clinical Nurse Specialist (cns) | Landmark Hospital of Columbia, LLC | 604 Old 63, Columbia, MO 65201-6308 |
| Street Address |
604 OLD 63 |
| City | COLUMBIA |
| State | MO |
| Zip | 65201-6308 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ricardo A Hernandez | Critical Care (intensivists) | Landmark Hospital of Columbia, LLC | 604 Old 63, Columbia, MO 65201-6308 |
| Delali K Buatsi | Hospitalist | Landmark Hospital of Columbia, LLC | 604 Old 63, Columbia, MO 65201-6308 |
| Tareq M Abu Salah | Pulmonary Disease | Landmark Hospital of Columbia, LLC | 604 Old 63, Columbia, MO 65201-6308 |
| Norvin E Thomas | Pulmonary Disease | Landmark Hospital of Columbia, LLC | 604 Old 63, Columbia, MO 65201-6308 |
| Julie M Lewis | Certified Clinical Nurse Specialist (cns) | Landmark Hospital of Columbia, LLC | 604 Old 63, Columbia, MO 65201-6308 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gerald H Heisler | Clinical Psychologist | 1316 S Old Hwy 63, Columbia, MO 65201 | |
| Amanda J Fischer | General Surgery | Columbia Surgical Services Inc | 3220 Bluff Creek Dr, Suite 100, Columbia, MO 65201-3525 |
| Erica H Salinas | Vascular Surgery | Columbia Surgical Services Inc | 3220 Bluff Creek Dr, Suite 100, Columbia, MO 65201-3525 |
| Jennifer Lynn Sanford | Vascular Surgery | Columbia Surgical Services Inc | 3220 Bluff Creek Dr, Suite 100, Columbia, MO 65201-3525 |
| Jane A Vaughan | Nurse Practitioner | Columbia Surgical Services Inc | 3220 Bluff Creek Dr, Suite 100, Columbia, MO 65201-3525 |
| Ashley Marie Hardesty | Nurse Practitioner | Columbia Surgical Services Inc | 3220 Bluff Creek Dr, Suite 100, Columbia, MO 65201-3525 |
| John G Adams Jr. | Vascular Surgery | Columbia Surgical Services Inc | 3220 Bluff Creek Dr, Suite 100, Columbia, MO 65201-3525 |
| Kimberly C Suppes | General Surgery | Columbia Surgical Services Inc | 3220 Bluff Creek Dr, Suite 100, Columbia, MO 65201-3525 |
| Erik M Grossmann | Colorectal Surgery (proctology) | Columbia Surgical Services Inc | 3220 Bluff Creek Dr, Suite 100, Columbia, MO 65201-3525 |
| Jeffrey Roland Nolting | Psychologist, Clinical | Deer Oaks Mental Health Associates PC | 3105 Bluff Creek Dr, Columbia, MO 65201-3529 |
| Find all physicians in zip 65201 | |||
| City | COLUMBIA |
| Zip Code | 65201 |
| Specialty | HOSPITALIST |
| City + Specialty | COLUMBIA + HOSPITALIST |
Please comment or provide details below to improve the information on Elbert S Tillerson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.