ABIGAIL TILLMAN (NPI# 1326488347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326488347 |
| Entity Type | Individual |
| Full Name | ABIGAIL TILLMAN |
| Credential | MD |
| Practice Address |
1666 E Bert Kouns Industrial Loop Shreveport LA 71105 |
| Mailing Address |
1666 E Bert Kouns Industrial Loop Shreveport LA 71105-5714 |
| Practice Telephone | 3182123520 |
| Practice Fax Number | 3182123525 |
| Mailing Telephone | 3182123520 |
| Mailing Fax Number | 3182123525 |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2019-12-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 312752 | LA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 56540 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 1326488347 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 265 Bruce Park Ave, Greenwich, CT 06830 | 2035615619 |
| Street Address |
1666 E BERT KOUNS INDUSTRIAL LOOP |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306875570 | Edward Ronald Samper | Emergency Medicine | 1666 E Bert Kouns Industrial Loop, Suite 105, Shreveport, LA 71105-5714 | 2006-07-01 |
| 1821127978 | Breast Care Specialists Amc | Surgery | 1666 E Bert Kouns Industrial Loop, Suite 230, Shreveport, LA 71105-5714 | 2007-03-05 |
| 1891822714 | Cheryl Austin Smith, Md, Inc. | Family Medicine | 1666 E Bert Kouns Industrial Loop, Suite 225, Shreveport, LA 71105-5714 | 2007-02-27 |
| 1073612727 | Swearingen and Bryan | Specialist | 1666 E Bert Kouns Industrial Loop, Ste 235, Shreveport, LA 71105-5714 | 2006-09-21 |
| 1235247230 | Cheryl A Smith | Family Medicine | 1666 E Bert Kouns Industrial Loop, Suite 225, Shreveport, LA 71105-5714 | 2006-08-29 |
| 1598797789 | Stephen Alan Smith | Family Medicine | 1666 E Bert Kouns Industrial Loop, Suite 105, Shreveport, LA 71105-5714 | 2006-07-07 |
| 1003847013 | Paul S Wilson Md and Willis-knighton Medical Center | Internal Medicine | 1666 E Bert Kouns Industrial Loop, Suite 230, Shreveport, LA 71105-5714 | 2006-07-06 |
| 1629008214 | John Gordon Goddard | Family Medicine | 1666 E Bert Kouns Industrial Loop, Suite 105, Shreveport, LA 71105-5714 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922621390 | Partners In Primary Care La PC | Family Medicine | 7551 Youree Dr Ste 11, Shreveport, LA 71105-5533 | 2020-05-20 |
| 1528609104 | Spectra Family Clinic, LLC | Family Medicine | 9300 Mansfield Rd Ste 209, Shreveport, LA 71118-3138 | 2019-10-04 |
| 1922502327 | Courtney Morgan | Family Medicine | 723 Milam St, Shreveport, LA 71101-3507 | 2018-03-20 |
| 1174973317 | Patrick Michael Fitz-gerald | Family Medicine | 731 Coachlight Rd, Shreveport, LA 71106-7205 | 2016-06-19 |
| 1437446341 | Samreena N Sara | Family Medicine | 8835 Line Ave Ste 400a, Shreveport, LA 71106-6722 | 2011-06-30 |
| 1932490554 | Michael Thomas Kitchell | Family Medicine | 1666 E Bert Koun Loop Ste 105, Shreveport, LA 71105-5718 | 2011-04-30 |
| 1831402254 | David J. Colvin Md LLC | Family Medicine | 148 Waters Edge Dr, Shreveport, LA 71106-7774 | 2010-07-15 |
| 1952628802 | Tri Pham | Family Medicine | 133 Charles Ave, Shreveport, LA 71105-3719 | 2010-04-30 |
| 1669799524 | Stephanie James | Family Medicine | 2120 Bert Kouns Industrial Loop Ste M, Shreveport, LA 71118-3355 | 2010-04-30 |
| 1205062965 | Charles Henry Nash | Family Medicine | 5935 Gilbert Dr, Shreveport, LA 71106-2315 | 2009-06-08 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.