DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: BENNIE N TILL MD

MEDICARE: BENNIE N TILL MD
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
1207Q00000XFamily Medicine Physician29706MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080037689OTHERTRAVELERS MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235118928
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENNIE N TILL MD
Provider Business Mailing Address
First Line : PO BOX 220
Second Line :
City : POPLAR BLUFF
State : MO
Zip : 63902-0220
Country : US
Telephone Number : 573-686-2411
Fax Number : 573-686-8452
Provider Business Practice Location Address
First Line : 686 LESTER ST
Second Line :
City : POPLAR BLUFF
State : MO
Zip : 63901-5025
Country : US
Telephone Number : 573-686-2411
Fax Number : 573-686-8452
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2006
Last Update Date : 09/01/2011

Similar Medicare Providers

1811312036 — CASSONDRA A OGLESBY LBA
Practice Location Address:
686 LESTER ST
POPLAR BLUFF, MO
63901-5025
Practice Phone: 573-686-1200
Practice Fax:
1568325132 — BREANNE GAIL SHEPHERD
Practice Location Address:
686 LESTER ST
POPLAR BLUFF, MO
63901-5025
Practice Phone: 573-686-1200
Practice Fax:
1730042300 — LEAH FAITH JACKSON PLPC
Practice Location Address:
686 LESTER ST
POPLAR BLUFF, MO
63901-5025
Practice Phone: 573-686-1200
Practice Fax:
1114905346 — DEBRA S PRICE FNP
Practice Location Address:
686 LESTER ST
POPLAR BLUFF, MO
63901-5025
Practice Phone: 573-686-2411
Practice Fax: 573-778-7271
1730168592 — WENDELL H ELLIOTT MD
Practice Location Address:
686 LESTER ST
POPLAR BLUFF, MO
63901-5025
Practice Phone: 573-686-2411
Practice Fax: 573-686-8452
1649259409 — GARY W DAUSMANN MD
Practice Location Address:
686 LESTER ST
POPLAR BLUFF, MO
63901-5025
Practice Phone: 573-686-2411
Practice Fax: 573-686-8452

Directions to “ BENNIE N TILL MD” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.