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General NPI Number Information
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NPI Number | 1487844296
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Entity Type | Individual
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Provider Name | DOUGLAS M. TILTON M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 04/30/2024
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Provider Practice Location Address
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Address Line | 36000 DARNALL LOOP, BOX 48 RADIOLOGY DEPARTMENT
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City | FT. HOOD
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State | TX
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Zip | 76544
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Country | US
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Telephone | 254-288-8300
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Fax | 254-288-8924
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Provider Business Mailing Address
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Address Line | 36000 DARNALL LOOP, BOX 48 RADIOLOGY DEPARTMENT
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City | FT. HOOD
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State | TX
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Zip | 76544
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Country | US
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Telephone | 254-288-8300
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Fax | 254-288-8924
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 01055369A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 01055369A
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License Number State | IN
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