Individual
DR. JAMES EDWARD TISDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSCPHARM, PHARMD
Contact information
Practice address
1001 W 10TH ST, W7555 MYERS BLDG, WHS, PURDUE UNIVERSITY, INDIANAPOLIS, IN 46202-2859
(317) 613-2315
(317) 613-2316
Mailing address
13787 HICKORY RIDGE CT, CARMEL, IN 46032-9128
(317) 613-2315
(317) 613-2316
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
26021035A
IN
1835P1200X
Pharmacotherapy Pharmacist
5302028422
MI
Other
Enumeration date
12/09/2006
Last updated
07/08/2007
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