Individual
DR. JAMES NICHOLAS TISDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3555 GREENWOOD RD, SHREVEPORT, LA 71109-5209
(318) 525-0144
Mailing address
3501 CHAMPION LAKE BLVD, APT. 1609, SHREVEPORT, LA 71105-3772
(318) 564-1057
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST019166
LA
Other
Enumeration date
09/14/2010
Last updated
09/14/2010
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