Tisdall, Philip A
Tisdall, Philip A is an individual health care provider with primary practice located at 1 Hampton Rd Unit 208, Exeter NH 03833-4849. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Tisdall, Philip A can be contacted via phone (603) 778-8522.Contact Information
Primary practice address
1 Hampton Rd Unit 208
Exeter NH 03833-4849
Phone: (603) 778-8522
Fax: (603) 778-1602
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 7703 | New Hampshire |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 57504 | Massachusetts |
Profile Details
| NPI number | 1578566774 |
|---|---|
| LBN Legal business name | Tisdall, Philip A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2005 |
| Last updated | Jun 3rd, 2008 - about 16 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 | 1578566774 | NPPES |
| Massachusetts | MEDICAID | 3021904 | |
| Massachusetts | Other | 0105363Y0HN01 | |
| Massachusetts | MEDICAID | 30002058 | |
| Massachusetts | Other | 57504 | |
| Massachusetts | Other | 7703 | |
| Massachusetts | Other | R01137 |
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