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

Ethan Tillotson, MD

Individual provider Family Medicine Physician · NPI 1194175273

Ethan Tillotson, MD is a Family Practice in Tupelo, Mississippi. Graduated from University of Mississippi School of Medicine in 2016, 10 years ago. Practices with North Mississippi Faculty Practice Plan LLC, an 8-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
10
Trained at
University of Mississippi School of Medicine
Licensed in
MS
In the registry since
2016
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1665 S Green St
Tupelo, MS 38804-6556
Phone: (662) 377-2189
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 25270 (MS)

Record details

NPI number1194175273
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 20, 2016
Last updated in NPPESJune 20, 2022
Certification dateJune 20, 2022
Mailing address1665 S Green St, Tupelo, MS 38804-6556

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice North Mississippi Faculty Practice Plan Llc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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