Individual
DAVID TILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2601 SPENCER RD, SPENCER, OK 73084-3649
(405) 427-2441
(405) 427-4741
Mailing address
5300 N INDEPENDENCE AVE, SUITE 280, OKLAHOMA CITY, OK 73112-5556
(405) 427-2441
(405) 427-4741
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
Primary
26522
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MDG232
PREFERRED CARE
—
01
—
P00115455
RAILROAD MEDICARE
—
01
—
P010204490
BLUE CHOICE
—
Enumeration date
07/31/2006
Last updated
09/30/2014
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