Individual
DR. SARA E. TISDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6001 E WOODMEN RD, RM 5242, COLORADO SPRINGS, CO 80923-2601
(719) 571-5242
(719) 571-5248
Mailing address
6001 E WOODMEN RD, RM 5242, COLORADO SPRINGS, CO 80923-2601
(719) 571-5242
(719) 571-5248
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
45990
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99753570
—
CO
Enumeration date
05/15/2007
Last updated
12/19/2008
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