CHARLES GIRARD TISDALE

SHREVEPORT, LA
NPI1821096686
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: LA  PA.A10284)
Additional Taxonomies363AS0400X Physician Assistant, Surgical
(Licence: LA  A10284)
Enumeration Date2005-07-14
Last Update Date2024-08-23
Business Address
CHARLES GIRARD TISDALE PA-C
1455 E BERT KOUN LOOP #210
SHREVEPORT, LA 71105-5634
Phone number: 318-798-4623
Mailing Address
CHARLES GIRARD TISDALE PA-C
1455 E BERT KOUN LOOP #210
SHREVEPORT, LA 71105-5634
Phone number: 318-798-4623
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