| Mr Austin Dale Tiller, PA-C | |
|
7400 Lynn Ave, Hamlin, WV 25523-1138 | |
| (304) 824-5806 | |
| (304) 824-5804 |
| Full Name | Mr Austin Dale Tiller |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 6 Years |
| Location | 7400 Lynn Ave, Hamlin, West Virginia |
| 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 |
|---|---|---|---|
| 1235774910 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | (NU) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (NU) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lincoln County Primary Care Center Inc | 6204821879 | 40 |
| Entity Name | Lincoln County Primary Care Center Inc |
|---|---|
| Entity Type | Part B Supplier - Public Health/welfare Agency |
| Entity Identifiers | NPI Number: 1942274543 PECOS PAC ID: 6204821879 Enrollment ID: O20040415000138 |
| Entity Name | Lincoln County Primary Care Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457610594 PECOS PAC ID: 6204821879 Enrollment ID: O20121005000142 |
| Entity Name | Lincoln County Primary Care Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720586472 PECOS PAC ID: 6204821879 Enrollment ID: O20180703001013 |
| Entity Name | Lincoln County Primary Care Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821790692 PECOS PAC ID: 6204821879 Enrollment ID: O20230910000152 |
| Entity Name | Lincoln County Primary Care Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912609785 PECOS PAC ID: 6204821879 Enrollment ID: O20231005002729 |
| Entity Name | Lincoln County Primary Care Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528768322 PECOS PAC ID: 6204821879 Enrollment ID: O20231020000498 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Austin Dale Tiller, PA-C 7400 Lynn Ave, Hamlin, WV 25523-1138 Ph: (304) 824-5806 | Mr Austin Dale Tiller, PA-C 7400 Lynn Ave, Hamlin, WV 25523-1138 Ph: (304) 824-5806 |
Mara Wright Sutphin, P.A.-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 7400 Lynn Ave, Hamlin, WV 25523 Phone: 304-824-5806 Fax: 304-824-5804 |
Michael L Grome, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 7400 Lynn Ave, Hamlin, WV 25523 Phone: 304-824-5806 Fax: 304-824-5885 |
Lorin Belcher, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 7400 Lynn Ave, Hamlin, WV 25523 Phone: 304-824-5806 |
Thomas Belford, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 7400 Lynn Ave, Hamlin, WV 25523 Phone: 304-824-5806 Fax: 304-824-5804 |
Mrs. Courtney Kovach Reynolds, PA C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 7400 Lynn Ave, Hamlin, WV 25523 Phone: 304-824-5806 Fax: 304-824-5804 |