Individual
DR. RONALD COURY TISDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1023 MEDICAL CENTER PKWY, SELMA, AL 36701-6750
(650) 387-2272
Mailing address
625 19TH ST S, BIRMINGHAM, AL 35233-1900
(650) 387-2272
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
207P00000X
Emergency Medicine Physician
MD.41401
AL
207Q00000X
Family Medicine Physician
Primary
MD.41401
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/01/2017
Last updated
09/02/2020
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