NPI 1821096686 CHARLES GIRARD TISDALE PA-C SHREVEPORT LA. Find Phone Number, Address, Contact details of medical healthcare providers | NPI Number Lookup

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Charles Girard Tisdale - NPI: 1821096686

National Provider Identifier (NPI) is a 10-digit identification number which is issued to health care providers by the Centers for Medicare and Medicaid Services (CMS) in the United States(US). The NPI is introduced to replace of UPIN (unique provider identification number) and now NPI is the only required identifier for Medicare services, and NPI is also used by commercial healthcare insurers and by other payers.

Doctor Name: CHARLES GIRARD TISDALE
NPI Number: 1821096686
Entity Type Code: Individual (1)
Gender: M
Credentials: PA-C
License Number: A10284
Business Practice Address: 1500 Line Avenue
Ste. 200 Shreveport, LA - 71101
Business Phone Number: 3186295555
Business Fax Number: 3186295556
Mailing Address: 1500 Line Avenue, Ste. 200
SHREVEPORT
State: LA
Postal Code: 71101
Phone Number: 3186295555
Fax Number: 3186295556
NPI Enumeration Date: 07/14/2005
NPI Last Update Date: 05/26/2016
Replacement NPI: 0
NPI Deactivation Date:
NPI Reactivation Date:

Taxonomy Information:

Healthcare Provider Taxonomy: 363AS0400X
License Number: A10284
Healthcare Provider Taxonomy:
(Secondary)
N
State: LA
Taxonomy Type: Physician Assistants & Advanced Practice Nursing Providers
Taxonomy Classification: Physician Assistant
Taxonomy Specialization: Surgical
Taxonomy Definition:


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