| Provider / Organization | NPI | Date Certified |
|---|---|---|
| LAUREN ELIZABETH TISDALE | 1285258913 | 2024-08-11 |
Lauren Elizabeth Tisdale is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1285258913. Registration indicates Lauren Elizabeth Tisdale is a provider of services with a specialization in Dermatology (Allopathic & Osteopathic Physicians, Dermatology) (Specialist Network, ) (Dermatology, Allopathic & Osteopathic Physicians)
| Entity Type | Individual |
| Provider Name | Lauren Elizabeth Tisdale MD |
| Practice Office Address | 2885 BOONES CREEK RD JOHNSON CITY, TN US |
| Practice Office Telephone | 4239289014 |
| Mailing Address | 2300 W STONE DR KINGSPORT, TN 376602360 US |
| Business Telephone | 4232464961 |
| Business Fax | 4232453136 |
| Code | Practice | License No State |
|---|---|---|
| 207N00000X PRIMARY | Dermatology Allopathic & Osteopathic Physicians Dermatology Specialist Network Dermatology Allopathic & Osteopathic Physicians | 71625
TN |