Individual
FREDERICK W TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
806 DIXIE ST, CARROLLTON, GA 30117-4416
(770) 834-2071
(770) 834-1007
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT000968
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000233593B
—
GA
Enumeration date
11/08/2006
Last updated
10/11/2024
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