Charles Girard Tisdale, PA-C
NPI #1821096686 in Shreveport, Louisiana
Provider Information
- NPI Number
- 1821096686
- Entity Type
- Individual
- Name
- Charles Girard Tisdale, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant - Surgical
- Credential
- PA-C
- Enumeration Date
- Jul 14, 2005
- Last Updated
- Nov 24, 2025
Practice Location
- Address
- 1500 LINE AVE STE 100
- City
- Shreveport
- State
- Louisiana
- ZIP Code
- 71101-4644
- Phone
- (318) 635-3052
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Surgical — Surgical |
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