Individual
DR. BRETT BIENVILLE TISDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1017 DELAWARE AVE, MCCOMB, MS 39648-3827
(601) 250-1122
(601) 250-0290
Mailing address
1017 DELAWARE AVE, MCCOMB, MS 39648-3827
(601) 250-1122
(601) 250-0290
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
13987
MS
Other
Enumeration date
01/10/2006
Last updated
03/16/2015
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