Individual provider Active NPI

Paul A Tilton, M.D.

  • Family Medicine Physician
  • Maxwell Afb, AL
National Provider Identifier
1033266192
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01063098A Issued in IN
Practice address
300 Twining St BLDG 760
Maxwell Afb, AL 36112-6027
Phone
(334) 953-5200
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01063098A IN Primary

Addresses

Primary practice location

300 Twining St BLDG 760
Maxwell Afb, AL 36112-6027

Mailing address

300 Twining St BLDG 760
Maxwell Afb, AL 36112-6027
Phone (334) 953-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130508000276 FL Order and Referring Only - Family PracticePractitioner - Family Practice 6204073455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01063098AINMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1033266192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 TWINING ST BLDG 760",
            "city": "MAXWELL AFB",
            "state": "AL",
            "postal_code": "361126027",
            "telephone_number": "334-953-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TWINING ST BLDG 760",
            "city": "MAXWELL AFB",
            "state": "AL",
            "postal_code": "361126027",
            "telephone_number": "334-953-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILTON",
        "first_name": "PAUL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01063098A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maxwell Afb, AL

Sources for this page

Verify at the official NPI Registry.