Individual
TIFFANY LOY TISEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2250
(833) 643-8146
Mailing address
PO BOX 18667, ERLANGER, KY 41018-0667
(419) 704-9458
(833) 643-8146
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
02008487A
IN
207P00000X
Emergency Medicine Physician
Primary
06148
KY
Other
Enumeration date
03/19/2019
Last updated
11/10/2025
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