Provider Demographics
NPI:1154728327
Name:BARTMAN, TILFORD
Entity type:Individual
Prefix:
First Name:TILFORD
Middle Name:
Last Name:BARTMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1657 MERRIMAC TRAIL
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3090 CIDER HOUSE ROAD
Practice Address - Street 2:
Practice Address - City:TOANO
Practice Address - State:VA
Practice Address - Zip Code:23168
Practice Address - Country:US
Practice Address - Phone:757-741-2109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040087521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical