Provider Demographics
NPI:1609397686
Name:TILLMAN, WILLIAM H III (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:TILLMAN
Suffix:III
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1015 MONTLIMAR DR STE A210
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-1743
Mailing Address - Country:US
Mailing Address - Phone:251-461-4243
Mailing Address - Fax:251-450-4323
Practice Address - Street 1:2419 GORDON SMITH DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-2318
Practice Address - Country:US
Practice Address - Phone:251-434-3475
Practice Address - Fax:251-450-4323
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AL398282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program