| Charles Girard Tisdale, PA-C | |
|
1455 E Bert Koun Loop, #210, Shreveport, LA 71105-5634 | |
| (318) 798-4623 | |
| (318) 798-4569 |
| Full Name | Charles Girard Tisdale |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 27 Years |
| Location | 1455 E Bert Koun Loop, Shreveport, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821096686 | NPI | - | NPPES |
| 1626708 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AS0400X | Physician Assistant - Surgical | A10284 (Louisiana) | Secondary |
| 363AS0400X | Physician Assistant - Surgical | PA.A10284 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Specialists Hospital Shreveport | Shreveport, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Musculoskeletal Institute Of Louisiana Llc | 0143127415 | 26 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Girard Tisdale, PA-C 1455 E Bert Koun Loop, #210, Shreveport, LA 71105-5634 Ph: (318) 798-4623 | Charles Girard Tisdale, PA-C 1455 E Bert Koun Loop, #210, Shreveport, LA 71105-5634 Ph: (318) 798-4623 |
Tate James Perque, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1453 E Bert Kouns Industrial Loop Ste 318, Shreveport, LA 71105 Phone: 318-681-1968 Fax: 318-681-1969 | |
Jennifer B Cypher, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 | |
Mrs. Kristi Harrison Gaspard, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 8383 Millicent Way, Shreveport, LA 71115 Phone: 318-797-6661 Fax: 318-795-8512 | |
Susan Lenora Steen, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1501 Kings Hwy, Department Of Neurosurgery, Shreveport, LA 71103 Phone: 318-675-6901 Fax: 318-675-4819 | |
Jeanette Catherine Pang, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 7925 Youree Dr Ste 200, Shreveport, LA 71105 Phone: 318-212-3610 Fax: 318-212-3709 | |
Dakota Shayne Barlow, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 | |
Carson Shetley Holtzclaw, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 6841 Fern Ave Ste 100, Shreveport, LA 71105 Phone: 318-868-2273 Fax: 318-868-4219 |