Provider Demographics
NPI:1306238720
Name:TILTON, JAMES CHARLES (PA-C)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CHARLES
Last Name:TILTON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HILLCREST MEDICAL BLVD
Mailing Address - Street 2:EMERGENCY DEPT
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-8897
Mailing Address - Country:US
Mailing Address - Phone:254-202-2000
Mailing Address - Fax:
Practice Address - Street 1:100 HILLCREST MEDICAL BLVD
Practice Address - Street 2:EMERGENCY DEPT
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-8897
Practice Address - Country:US
Practice Address - Phone:254-202-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-22
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant