Individual
DR. BARRY FORREST TILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
107 FRONT ST, VIDALIA, LA 71373-2836
(318) 336-2216
(318) 336-6075
Mailing address
107 FRONT ST, VIDALIA, LA 71373-2836
(318) 336-2216
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
07480R
LA
207RP1001X
Pulmonary Disease Physician
11444
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115584
—
MS
05
—
1371483
—
LA
Enumeration date
10/07/2005
Last updated
01/11/2017
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