Tisdale, Chad Everett
Tisdale, Chad Everett is an individual health care provider with primary practice located at 1729 New Hanover Medical Park Dr , Wilmington NC 28403-5345. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Tisdale, Chad Everett can be contacted via phone (910) 763-3601.Contact Information
Primary practice address
1729 New Hanover Medical Park Dr
Wilmington NC 28403-5345
Phone: (910) 763-3601
Fax: (910) 763-4608
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2178 | North Carolina |
Profile Details
| NPI number | 1992031934 |
|---|---|
| LBN Legal business name | Tisdale, Chad Everett |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2009 |
| Last updated | Oct 27th, 2020 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992031934 | NPPES |
| North Carolina | MEDICAID | 5913156 |
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