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Individual

TIMOTHY TISDALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
188 HOSPITAL DR STE 100, FAIRHOPE, AL 36532-2038
(251) 607-9797
Mailing address
2451 UNIVERSITY HOSPITAL DR, MOBILE, AL 36617-2300

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.1693
AL

Other

Enumeration date
01/13/2021
Last updated
09/11/2023
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