Tillman, Marshall Perry
Tillman, Marshall Perry is an sole proprietor health care provider with primary practice located at 812 W Wade Hampton Blvd , Greer SC 29650-1309. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Tillman, Marshall Perry can be contacted via phone (864) 877-1825.Contact Information
Primary practice address
812 W Wade Hampton Blvd
Greer SC 29650-1309
Phone: (864) 877-1825
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2109 | Minnesota |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2303 | South Carolina |
Profile Details
| NPI number | 1245349919 |
|---|---|
| LBN Legal business name | Tillman, Marshall Perry |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 29th, 2006 |
| Last updated | Aug 25th, 2022 - about 3 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 | 1245349919 | NPPES |
| Minnesota | MEDICAID | 478523100 | |
| Minnesota | Other | 48379 | |
| Minnesota | Other | 333471032669 | |
| Minnesota | Other | 52M69TI | |
| Minnesota | Other | 15952 | |
| Minnesota | Other | 22-01918 |
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