Tiller, Ronald D

Tiller, Ronald D is an individual health care provider with primary practice located at 640 E 700 S Suite 203, St George UT 84770-4023. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Tiller, Ronald D can be contacted via phone (435) 574-9777.

Contact Information

Primary practice address
640 E 700 S Suite 203 St George UT 84770-4023
Phone: (435) 574-9777
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA02801 Texas

Profile Details

NPI number 1881630572
LBN Legal business name Tiller, Ronald D
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated Apr 30th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881630572 NPPES
New Mexico MEDICAID 72328878
New Mexico MEDICAID 216611801
New Mexico Other 8N9977

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