Charles Donovan Tiller, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

013142 Issued in LA

Practice address

510 East Stoner Avenue
Shreveport, LA 71101-4295

Phone

(318) 221-8411

Fax

(318) 429-5750

NPI assigned

Aug 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Chuck Tiller Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447263777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4351 FINLEY DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711053213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 EAST STONER AVENUE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014295",
            "telephone_number": "318-221-8411",
            "fax_number": "318-429-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "CHARLES",
        "middle_name": "DONOVAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "26491",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "013142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHUCK",
            "last_name": "TILLER",
            "prefix": "DR.",
            "credential": "PHARMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• James Edward Thrower Jr., LCSW
• Moe Thuzar
• Gary W Tiemann, LCSW
• Dwight A Tietjen Jr., P.T.
• William Jeffery Till, M.D.
• Lensey Wells Tiller, FNP-C
• Megyn Reese Tiller, PHARM.D.
• Charles L Tilley Jr.
• Marimel S. Tilley, O.D.
• Arneka S Tillman, PHARMD

• Pharmacist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Pharmacist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.