Robert Sidney Tillett Jr, MD | |
3991 Dutchmans Ln Ste 310, Louisville, KY 40207-4716 | |
(502) 899-6782 | |
(502) 899-6783 |
Full Name | Robert Sidney Tillett Jr |
---|---|
Gender | Male |
Speciality | Psychiatry & Neurology - Neurology |
Location | 3991 Dutchmans Ln Ste 310, Louisville, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1134109465 | NPI | - | NPPES |
50030136 | Other | KY | PASSPORT/PASSPORT ADVANTAGE - NNS |
000000693343 | Other | KY | ANTHEM - NNS |
118916 | Other | KY | SIHO - NNS |
000057043W | Other | KY | HUMANA - NNS |
100388800 | Medicaid | IN | |
2542960 | Other | KY | CIGNA - NNS |
64202666 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | 20266 (Kentucky) | Primary |
Entity Name | Community Medical Associates Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1588614994 PECOS PAC ID: 7012811284 Enrollment ID: O20031120000656 |
Mailing Address | Practice Location Address |
---|---|
Robert Sidney Tillett Jr, MD Po Box 776351, Chicago, IL 60677-6351 Ph: (502) 272-5395 | Robert Sidney Tillett Jr, MD 3991 Dutchmans Ln Ste 310, Louisville, KY 40207-4716 Ph: (502) 899-6782 |
Dr. Christopher R. Shafer, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 401 E Chestnut St, Suite 510, Louisville, KY 40202 Phone: 502-588-4800 Fax: 502-588-4801 | |
David James Haustein, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 220 Abraham Flexner Way # 1200, Louisville, KY 40202 Phone: 502-584-3377 | |
Elizabeth B. Shelton, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 4010 Dupont Cir, Ste 312, Louisville, KY 40207 Phone: 812-282-1888 Fax: 812-285-8392 | |
Manoocher Mofidi, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 2225 W Broadway, Louisville, KY 40211 Phone: 502-589-8600 Fax: 502-589-8771 | |
Dr. Steven B Lippmann, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 550 S Jackson St, Louisville, KY 40202 Phone: 502-852-1759 Fax: 502-852-5098 | |
Tanya Wozniak, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 4201 Springhurst Blvd Ste 203, Louisville, KY 40241 Phone: 502-425-6690 Fax: 502-890-2092 | |
Bryan Jessop Eckerle, Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 3 Audubon Plaza Dr, Ll2, Louisville, KY 40217 Phone: 502-636-4940 Fax: 502-636-4941 |