Paul J Tilson, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

020839 Issued in GA

Practice address

412 Northside Dr E
#500
Statesboro, GA 30458-4802

Phone

(912) 764-6808

Fax

(912) 764-2436

NPI assigned

Aug 23, 2005

Last updated

Nov 24, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Statesboro Urologic Clinic, PC

  • Urology Physician
  • Statesboro, GA
  • NPI 1285662866
  NPD Authorized official

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1922091214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 NORTHSIDE DR E",
            "address_2": "#500",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584802",
            "telephone_number": "912-764-6808",
            "fax_number": "912-764-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 NORTHSIDE DR E",
            "address_2": "#500",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584802",
            "telephone_number": "912-764-6808",
            "fax_number": "912-764-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILSON",
        "first_name": "PAUL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "020839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051284",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000264382A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thrive Health and Wellness LLC
• Caroline Thurman, LPC
• Courtenay L Tillman, FNP-BC
• Kelly Tillman
• Carlie Tilson
• Lynly Rose Timmerman
• Todd Allen MD PC
• Jessica Todd
• Toi L. Curry, Psy.D., P.C.
• Brenda Leigh Tolksdorf, CRNA

• Urology Physician in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Urology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.