Detra Michelle Tisdale in Cordova - Internal Medicine
Detra Michelle Tisdale - NPI 1730273079
Detra Michelle Tisdale is a Internal Medicine in Cordova, Tennessee. Detra Michelle Tisdale practices all healthcare services and medical treatments related to Internal Medicine. The NPI Number for Detra Michelle Tisdale is 1730273079. The last update date is 2010-12-06.
Detra Michelle Tisdale's current location address is 1144 N Houston Levee Rd, Cordova, Tennessee. You can contact this provider via phone number 9013822044. The mailing address for Detra Michelle Tisdale is 1144 N Houston Levee Rd, Cordova, Tennessee. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Detra Michelle Tisdale |
|---|---|
| Address | 1144 N Houston Levee Rd, Cordova, Tennessee |
| Phone Number | 9013822044 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1730273079 |
|---|---|
| Provider Enumeration Date | 2006-10-03 |
| Last Updated Date | 2010-12-06 |
Provider Mailing Address Detail
| Address | 1144 N Houston Levee Rd |
|---|---|
| City | Cordova |
| State | Tennessee (TN) |
| Post Code | 380187145 |
| Phone Number | 9013822044 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Internal Medicine |
|---|---|
| Taxonomy | 207R00000X |
| Licence No | 53713 |
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Definition: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and di |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 6837219 | MS | -- | |
| 1369047 | LA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Detra Michelle Tisdale by the Centers for Medicare & Medicaid Services?
The Detra Michelle Tisdale has been issued the NPI (National Provider Identifier) 1730273079 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Detra Michelle Tisdale's facilities are geographically located?
The facilities of Detra Michelle Tisdale are physically situated at the following location: 1144 N Houston Levee Rd, Cordova, TN, 380187145.
What is Detra Michelle Tisdale's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Detra Michelle Tisdale is Internal Medicine, and the taxonomy classification code that categorizes this area of expertise is 207R00000X.
On what date did the Detra Michelle Tisdale receive its 1730273079 assignment from the Centers for Medicare & Medicaid Services?
The Detra Michelle Tisdale was assigned its 1730273079 by the Centers for Medicare & Medicaid Services on 2006-10-03.
As of what date were the details related to Detra Michelle Tisdale most recently updated or revised?
The information pertaining to Detra Michelle Tisdale, including its address, specialty, and other relevant details, was last updated or revised on 2010-12-06.
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