Weldon Tisdale JR.

NPI #1003420647 in Tulsa, Oklahoma

Provider Information

NPI Number: 1003420647
Entity Type: Individual
Name: Weldon Tisdale JR.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Case Manager/Care Coordinator
Enumeration Date: Sep 1, 2020
Last Updated: Sep 1, 2020

Practice Location

Address: 3606 N MLK JR BLVD
City: Tulsa
State: Oklahoma
ZIP Code: 74106-6447
Phone: (918) 949-4212

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X	Primary

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