CHARLES TISDALE, PA-C

Physician Assistant - Surgical

Active Individual
NPI: 1821096686

Practice Address

1500 LINE AVE STE 100
Shreveport, LA 71101

Phone: (318) 635-3052

Specialties

Specialty Code Primary License
Physician Assistant - Surgical 363AS0400X Yes PA.A10284 (LA)

Frequently Asked Questions

NPI 1821096686 is the National Provider Identifier for CHARLES TISDALE, PA-C, a Physician Assistant - Surgical provider located in Shreveport, LA. This NPI was enumerated on July 14, 2005.
CHARLES TISDALE, PA-C practices at 1500 LINE AVE STE 100, Shreveport, LA 71101.

Quick Facts

NPI
1821096686
Type
Individual
Enumerated
Jul 14, 2005
Last Updated
Nov 24, 2025

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