IndividualActive
Clifford Tillman
NPI 1053309732 · Gastroenterology Physician · Vidalia, LA
Provider details
- NPI number
- 1053309732
- Entity type
- Individual
- Primary specialty
- Gastroenterology PhysicianAllopathic & Osteopathic Physicians
- Sex
- Male
- Sole proprietor
- No
- License
- 06980R (LA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
107 Front St
Suite 2126
Vidalia, LA 71373-2836
Phone: (318) 336-2216
Fax: (318) 336-6074
Approximate (ZIP-level) locationGet directions
Mailing address
107 Front St
Vidalia, LA 71373-2836
Registry dates
- Enumerated
- 2005-10-07
- Last updated
- 2008-07-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.