Provider Demographics
NPI:1851490957
Name:TILTON, JOSIAH B IV (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSIAH
Middle Name:B
Last Name:TILTON
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4157
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79704-4157
Mailing Address - Country:US
Mailing Address - Phone:432-699-0306
Mailing Address - Fax:432-520-2181
Practice Address - Street 1:2706 W CUTHBERT AVE
Practice Address - Street 2:BUILDING B, STE 100
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-3885
Practice Address - Country:US
Practice Address - Phone:432-699-0306
Practice Address - Fax:432-520-2181
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK6364207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8161B0Medicare ID - Type Unspecified
TXG80548Medicare UPIN