Tisdale, Douglas
Tisdale, Douglas is an individual health care provider with primary practice located at 41 Mall Rd Lahey Hospital And Medical Center , Burlington MA 01805-3648. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Tisdale, Douglas can be contacted via phone (781) 744-8400.Contact Information
Primary practice address
41 Mall Rd Lahey Hospital And Medical Center
Burlington MA 01805-3648
Phone: (781) 744-8400
Fax: (781) 744-5245
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | 13131 | New Hampshire |
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | 153488 | Massachusetts |
Profile Details
| NPI number | 1316920416 |
|---|---|
| LBN Legal business name | Tisdale, Douglas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 22nd, 2005 |
| Last updated | Aug 13th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316920416 | NPPES |
| New Hampshire | MEDICAID | 3074335 |
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