Individual
DR. JEFFREY PAUL TILLINGHAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
969 N MASON RD STE 240, SAINT LOUIS, MO 63141-6338
(314) 542-0606
(314) 542-0212
Mailing address
969 N MASON RD STE 240, SAINT LOUIS, MO 63141-6338
(314) 542-0606
(314) 542-0212
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
R7B86
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030000959
RAILROAD MEDICARE
MO
01
—
118205
HEALTHLINK
MO
01
—
28644
BLUE SHIELD
MO
Enumeration date
02/14/2007
Last updated
04/25/2022
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