| Dr Clifford Randolph Tillman, | |
|
107 Front St, Suite 2126, Vidalia, LA 71373-2836 | |
| (318) 336-2216 | |
| (318) 336-6074 |
| Full Name | Dr Clifford Randolph Tillman |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 50 Years |
| Location | 107 Front St, Vidalia, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053309732 | NPI | - | NPPES |
| 0115585 | Medicaid | MS | |
| 1316521 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 06980R (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Sta Home Health And Hospice | Clinton, MS | Home health agency |
| Intensive Home Health Care, Inc | Vidalia, LA | Home health agency |
| Mobile Infirmary Medical Center | Mobile, AL | Hospital |
| Hardtner Medical Center | Olla, LA | Hospital |
| Riverland Medical Center | Ferriday, LA | Hospital |
| Merit Health Natchez | Natchez, MS | Hospital |
| Baptist Memorial Hospital North Ms | Oxford, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Singing River Health System | 3870405194 | 243 |
| Imc-diagnostic And Medical Clinic Llc | 2860399623 | 151 |
| Lasalle Parish Hospital Service District 1 | 6709781545 | 19 |
| Entity Name | Singing River Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083893937 PECOS PAC ID: 3870405194 Enrollment ID: O20031104000435 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Clifford Randolph Tillman, 107 Front St, Suite 2126, Vidalia, LA 71373-2836 Ph: (318) 336-2216 | Dr Clifford Randolph Tillman, 107 Front St, Suite 2126, Vidalia, LA 71373-2836 Ph: (318) 336-2216 |
Dr. Iley Floyd Dillon, M.D. Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 107 Front St, Suite 2109, Vidalia, LA 71373 Phone: 318-336-2215 Fax: 318-336-6074 | |
Dr. Barry Forrest Tillman, M.D. Gastroenterology Medicare: Medicare Enrolled Practice Location: 107 Front St, Vidalia, LA 71373 Phone: 318-336-2216 Fax: 318-336-6075 | |
Ibrahim Seki, MD Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 1812 Carter St, Vidalia, LA 71373 Phone: 318-336-7072 Fax: 318-336-7073 |