Individual
BARBARA ANN TISDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1517 TEXAS VALLEY RD, MARATHON, NY 13803-2939
(315) 729-8563
(607) 849-6634
Mailing address
1517 TEXAS VALLEY RD, MARATHON, NY 13803-2939
(315) 729-8563
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
162126
NY
Other
Enumeration date
07/17/2006
Last updated
03/19/2015
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