Charles P Tillman, O.D. Valid NPI

Individual provider · Optometrist · Eupora, MS

NPI

1275630626

Type

Individual (Type 1)

Primary specialty

Optometrist

Specialty group

Eye and Vision Services Providers

Taxonomy code

152W00000X

License number

519 (MS)

Sex

Male

Sole proprietor

Yes

Enumerated

2006-09-20

Last updated

2008-05-27