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ELBERT STINSON TILLERSON MD NPI 1003872714


NPI Information

NPI: 1003872714
Provider Name: ELBERT STINSON TILLERSON, MD
Classification: Hospitalist - 208M00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1125 MADISON ST.
JEFFERSON CITY, MO
ZIP 65102
Phone: (573) 635-7651
Get Directions

Elbert Stinson Tillerson, MD is a hospitalist in Jefferson City, MO with 23 years of experience. The provider is hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. Elbert Stinson Tillerson, MD NPI is 1003872714. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduation Year:2001

The provider's business location address is:

1125 MADISON ST.
JEFFERSON CITY, MO
ZIP 65102-128
Phone: (573) 635-7651
Fax: (573) 659-4515

The NPI 1003872714 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/21/2006 and was last updated on 1/15/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084P0800XPsychiatry & NeurologyPsychiatry2011041481MISSOURINo
2208M00000XHospitalist2011041481MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1054133OTHERGEORGIALICENSE
223919OTHERSOUTH CAROLINA1
31003872714MEDICAIDMISSOURI
4I46657MEDICARE UPINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.