Individual
PAUL J TILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
412 NORTHSIDE DR E, #500, STATESBORO, GA 30458-4802
(912) 764-6808
(912) 764-2436
Mailing address
412 NORTHSIDE DR E, #500, STATESBORO, GA 30458-4802
(912) 764-6808
(912) 764-2436
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
020839
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000264382A
—
GA
01
—
051284
BCBS
GA
Enumeration date
08/23/2005
Last updated
11/24/2009
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