Individual
LAUREN ELIZABETH TISDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2885 BOONES CREEK RD, JOHNSON CITY, TN 37615-8002
(423) 928-9014
Mailing address
2300 W STONE DR, KINGSPORT, TN 37660-2360
(423) 246-4961
(423) 245-3136
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
71625
TN
Other
Enumeration date
05/28/2020
Last updated
08/11/2024
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