Individual
DOUGLAS C TILT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1521 11TH AVE S, BIRMINGHAM, AL 35205-3503
(205) 996-2760
(205) 297-9411
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
(205) 297-9411
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
06824
AL
208D00000X
General Practice Physician
6824
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051517024
BLUE CROSS
AL
05
—
051553947
—
AL
01
—
110117930
RAILROAD MEDICARE
—
Enumeration date
03/10/2006
Last updated
07/22/2011
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