Tisdale, Bradford W

Tisdale, Bradford W is an individual health care provider with primary practice located at 3745 Holland Rd , Virginia Beach VA 23452-2847. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Tisdale, Bradford W can be contacted via phone (757) 962-8720.

Contact Information

Primary practice address
3745 Holland Rd Virginia Beach VA 23452-2847
Phone: (757) 962-8720
Fax: (757) 507-9004
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101034354 Virginia

Profile Details

NPI number 1871568139
LBN Legal business name Tisdale, Bradford W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Dec 27th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1871568139 NPPES
Virginia MEDICAID 005611695

Popular Providers