Individual
DR. WILLIAM THOMAS TILLAR III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
425 S MAIN ST, SUITE D, EMPORIA, VA 23847-2300
(434) 634-5195
(434) 634-0203
Mailing address
425 S MAIN ST, SUITE D, EMPORIA, VA 23847-2300
(434) 634-5195
(434) 634-0203
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000522
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022075
ANTHEM BC/BS OF VIRGINIA
VA
05
—
9201301
—
VA
Enumeration date
09/20/2006
Last updated
06/29/2010
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