Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tillman Medical Group PA

Organization Specialist · NPI 1043260615

Tillman Medical Group PA is a Specialist in Vidalia, Louisiana. Licensed in Louisiana. Registered with an NPI since 2006.

Licensed in
LA
In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

107 Frnt ST
Vidalia, LA 71373-2836
Phone: (318) 336-2216
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 5D595 (LA)

Record details

NPI number1043260615
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tana Archer — Accounts Manager · (318) 336-2216
NPI enumeratedMay 12, 2006
Last updated in NPPESJune 4, 2013
Mailing address107 Front St, Vidalia, LA 71373-2836