Individual
DR. JOSEPH A TISONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4000 KRESGE WAY STE P1503, LOUISVILLE, KY 40207-4605
(502) 456-2008
(502) 456-4440
Mailing address
1169 EASTERN PKWY, SUITE G 71, LOUISVILLE, KY 40217-1417
(502) 458-8661
(502) 456-4440
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
36418
KY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
36418
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000190947
ANTHEM BLUE CROSS BS
—
01
—
0956501
CIGNA HEALTHCARE
—
01
—
1144199
PASSPORT MEDICAID
KY
01
—
1301279
UNITED MINE WORKERS
—
05
—
200101410A
—
IN
01
—
220030335
RAILROAD MEDICARE
KY
01
—
290445
BLACK LUNG
—
05
—
64031354
—
KY
05
—
9801803000
—
WV
Enumeration date
07/25/2006
Last updated
12/07/2018
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