JACOB GARY TILLMAN NPI 1568722700

NPI Information

  • NPI: 1568722700
  • Provider Name: JACOB GARY TILLMAN
  • Classification: - 246ZS0400X
  • Entity Type: Individual
  • Address: 103 CONTINENTAL PL
    SUITE 405
    BRENTWOOD, TN
    ZIP 37027
  • Phone: (877) 977-4630

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NPI Details

Jacob Gary Tillman is a healthcare provider in Brentwood, TN. Jacob Gary Tillman NPI is 1568722700. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

103 CONTINENTAL PL
SUITE 405
BRENTWOOD, TN
ZIP 37027-041
Phone: (877) 977-4630
Fax: (888) 242-7469

The enumeration date for this NPI number is 5/22/2012 and was last updated on 5/22/2012.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1246ZS0400XYes

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: 11/21/2025

NPI Synchronization or Removal

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