| Zachary Tisdale, | |
|
14365 Highway 16 W, De Kalb, MS 39328-7974 | |
| (769) 486-1000 | |
| Not Available |
| Full Name | Zachary Tisdale |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 1 Years |
| Location | 14365 Highway 16 W, De Kalb, Mississippi |
| 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 |
|---|---|---|---|
| 1730048794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 907900 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Laird Hospital Inc | Union, MS | Hospital |
| Rush Foundation Hospital | Meridian, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Bonita Emergency Group Llc | 3870933278 | 27 |
| Mailing Address | Practice Location Address |
|---|---|
| Zachary Tisdale, 36 Melissa Loop, Petal, MS 39465-6303 Ph: (601) 550-0784 | Zachary Tisdale, 14365 Highway 16 W, De Kalb, MS 39328-7974 Ph: (769) 486-1000 |
Latorya Barron, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 201 Birch St, De Kalb, MS 39328 Phone: 601-743-2642 | |
Hannah Gray, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 201 Birch St, De Kalb, MS 39328 Phone: 601-743-2643 Fax: 601-553-8175 |