Provider Demographics
NPI:1447587514
Name:TILGHMAN, ELIZABETH MCCORMICK (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MCCORMICK
Last Name:TILGHMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:414 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-3845
Mailing Address - Country:US
Mailing Address - Phone:484-919-1854
Mailing Address - Fax:
Practice Address - Street 1:855 SPRINGDALE DR STE 120
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2836
Practice Address - Country:US
Practice Address - Phone:610-561-6100
Practice Address - Fax:610-524-0133
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA054019363A00000X
PAOA002415363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant