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GEORGE G. TISDALE M.D. NPI 1073659173


NPI Information

NPI: 1073659173
Provider Name: GEORGE G. TISDALE, M.D.
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

CLIA Number: 01D0890935

Address:
217 BROAD ST
SELMA, AL
ZIP 36701
Phone: (334) 875-5000
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GEORGE G. TISDALE, M.D. is a mohs-micrographic surgery dermatology in Selma, AL. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. GEORGE G. TISDALE, M.D. NPI is 1073659173. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

217 BROAD ST
SELMA, AL
ZIP 36701-589
Phone: (334) 875-5000

The provider's authorized official is George G. Tisdale .
The authorized official title is Medical Doctor and has the following contact phone number (334) 875-5000.

The CLIA number assigned to this NPI record is 01D0890935 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/29/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0101XDermatologyMOHS-Micrographic Surgery8522ALABAMAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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