| E A Tillman & Associates Inc | |
|
285 N Ferdon Blvd Crestview FL 32536-2751 | |
| (850) 682-2408 | |
| (850) 682-8755 |
| Full Name | E A Tillman & Associates Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 285 N Ferdon Blvd, Crestview, Florida |
| Authorized Official Name and Position | E A Tillman (PRESIDENT) |
| Authorized Official Contact | 8506822408 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| E A Tillman & Associates Inc 285 N Ferdon Blvd Crestview FL 32536-2751 Ph: (850) 682-2408 | E A Tillman & Associates Inc 285 N Ferdon Blvd Crestview FL 32536-2751 Ph: (850) 682-2408 |
| NPI Number | 1063509222 |
|---|---|
| Provider Enumeration Date | 10/09/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063509222 | NPI | - | NPPES |
| 977588 | Other | FL | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 9341 (Florida) | Primary |
| 1223G0001X | Dentist - General Practice | 3915 (Florida) | Secondary |
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