David Eugene Tisdale in Massena - Physician Assistant
David Eugene Tisdale - NPI 1396835112
David Eugene Tisdale is a Physician Assistant in Massena, New York. David Eugene Tisdale practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for David Eugene Tisdale is 1396835112. The last update date is 2015-02-06.
David Eugene Tisdale's current location address is 1 Hospital Dr, Massena, New York. You can contact this provider via phone number 3157694200. The mailing address for David Eugene Tisdale is 1 Hospital Dr, Massena, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | David Eugene Tisdale |
|---|---|
| Address | 1 Hospital Dr, Massena, New York |
| Phone Number | 3157694200 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | R-PCA |
NPI Number Detail
| NPI Number | 1396835112 |
|---|---|
| Provider Enumeration Date | 2006-10-13 |
| Last Updated Date | 2015-02-06 |
Provider Mailing Address Detail
| Address | 1 Hospital Dr |
|---|---|
| City | Massena |
| State | New York (NY) |
| Post Code | 136621056 |
| Phone Number | 3157694200 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 2506 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2506 | NY | PA LISCENCE | |
| 3773219 | NY | -- |
Post Comment/ Review Below
What is the David Eugene Tisdale's unique identification number?
The David Eugene Tisdale has been assigned the NPI (National Provider Identifier) Number 1396835112 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete street address where David Eugene Tisdale is physically located?
The David Eugene Tisdale is physically situated at the following address: 1 Hospital Dr, Massena, NY, 136621056.
What is the David Eugene Tisdale's area of specialization and corresponding taxonomy classification?
The David Eugene Tisdale's specialty field is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their specialties.
On what date did David Eugene Tisdale receive its 1396835112 assignment from the Centers for Medicare & Medicaid Services?
The David Eugene Tisdale was assigned its 1396835112 on 2006-10-13, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to David Eugene Tisdale last refreshed?
The information related to the David Eugene Tisdale, including its address, specialty, and other relevant details, was last updated on 2015-02-06.
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