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NPI Code Detail

MEDICARE: DR. WILLIAM JEFFERY TILL M.D.

MEDICARE: DR. WILLIAM JEFFERY TILL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician018534LA
22083P0500XPreventive Medicine/Occupational Environmental Medicine Physician018534LA

General Provider Information

NPI Number : 1851385215
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM JEFFERY TILL M.D.
Provider Business Mailing Address
First Line : 510 E STONER AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71101-4243
Country : US
Telephone Number : 318-221-8400
Fax Number :
Provider Business Practice Location Address
First Line : 510 E STONER AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71101-4243
Country : US
Telephone Number : 318-221-8400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2005
Last Update Date : 05/31/2023

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