Detra Tisdale, M.D

NPI 1730273079 · on the registry since 2006

Practice

Address: 1144 N Houston Levee Rd
Suite 102
Cordova, TN 38018
Phone: (901) 382-2044
Organisation at this address: National Transport, Inc
Leader Physical Therapy Limited Partnership
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy: 207R00000X
207R00000X
Also registered as: 207R00000X
207R00000X
Licence states on file: GA, LA, TN
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2010-12-06

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Tennessee