Tiller, Ronald D
Tiller, Ronald D is an individual health care provider with primary practice located at 640 E 700 S Suite 203, St George UT 84770-4023. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Tiller, Ronald D can be contacted via phone (435) 574-9777.Contact Information
Primary practice address
640 E 700 S Suite 203
St George UT 84770-4023
Phone: (435) 574-9777
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA02801 | Texas |
Profile Details
| NPI number | 1881630572 |
|---|---|
| LBN Legal business name | Tiller, Ronald D |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2006 |
| Last updated | Apr 30th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881630572 | NPPES |
| New Mexico | MEDICAID | 72328878 | |
| New Mexico | MEDICAID | 216611801 | |
| New Mexico | Other | 8N9977 |
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