Provider Demographics
NPI:1609397686
Name:TILLMAN, WILLIAM H III (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:TILLMAN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 MONTLIMAR DR STE A210
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-1743
Mailing Address - Country:US
Mailing Address - Phone:251-461-4243
Mailing Address - Fax:251-450-4323
Practice Address - Street 1:1015 MONTLIMAR DR STE A210
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-1743
Practice Address - Country:US
Practice Address - Phone:251-461-4243
Practice Address - Fax:251-450-4323
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program