Provider Demographics
NPI:1962504886
Name:TILLEY, ROBERT LEE (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEE
Last Name:TILLEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1390 US HIGHWAY 61
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-4137
Mailing Address - Country:US
Mailing Address - Phone:636-937-3121
Mailing Address - Fax:636-937-4423
Practice Address - Street 1:1390 US HIGHWAY 61
Practice Address - Street 2:SUITE 2300
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4137
Practice Address - Country:US
Practice Address - Phone:636-937-3121
Practice Address - Fax:636-937-4423
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2013-04-03
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Provider Licenses
StateLicense IDTaxonomies
MO2013004555207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease