Tillman, Johnie Stuart
Tillman, Johnie Stuart is an individual health care provider with primary practice located at 300 W Hospital Rd Attn: Credentials, Fort Gordon GA 30905-5741. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Tillman, Johnie Stuart can be contacted via phone (706) 592-6722.Contact Information
Primary practice address
300 W Hospital Rd Attn: Credentials
Fort Gordon GA 30905-5741
Phone: (706) 592-6722
Fax: (706) 787-8176
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 029995 | Georgia |
Profile Details
| NPI number | 1124282090 |
|---|---|
| LBN Legal business name | Tillman, Johnie Stuart |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2008 |
| Last updated | Jul 10th, 2008 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124282090 | NPPES |
| Georgia | Other | VAD 000 | MILITARY TREATMENT FACILITY |
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