Tillerson, Elbert Stinson

Tillerson, Elbert Stinson is an individual health care provider with primary practice located at 1125 Madison St. , Jefferson City MO 65102-1128. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Tillerson, Elbert Stinson can be contacted via phone (573) 635-7651.

Contact Information

Primary practice address
1125 Madison St. Jefferson City MO 65102-1128
Phone: (573) 635-7651
Fax: (573) 659-4515
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 2011041481 Missouri
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 2011041481 Missouri

Profile Details

NPI number 1003872714
LBN Legal business name Tillerson, Elbert Stinson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2006
Last updated Jan 15th, 2013 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003872714 NPPES
Georgia Other 054133 LICENSE
Georgia Other 23919 LICENSE
Georgia MEDICAID 1003872714 LICENSE

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