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Individual

MR. KENNETH G TILGHMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10442 MIDLOTHIAN TPKE, RICHMOND, VA 23235-4408
(804) 560-9240
(804) 560-9242
Mailing address
4107 TWEEDSMUIR RD, MOSELEY, VA 23120-1290
(804) 639-5106

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101054150
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
061663496
TRICARE
VA
01
129450
AETNA
VA
01
13733
SENTARA OPTIMA
VA
01
202874
SOUTHERN HEALTH
VA
01
40340
CARENET
VA
01
462448
ANTHEM
VA
05
6738125
VA
01
8100327
MAMSI UNITEDHEALTHCARE
VA
Enumeration date
07/19/2006
Last updated
07/23/2013
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