Healthcare Provider Details

I. General information

NPI: 1245783976
Provider Name (Legal Business Name): AARON PAUL TILLMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2016
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 RIVERCHASE DR
PHENIX CITY AL
36867-7483
US

IV. Provider business mailing address

602 FARRAH CIR
DOTHAN AL
36301-2112
US

V. Phone/Fax

Practice location:
  • Phone: 334-732-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number112210
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT31535
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: