George G. Tisdale, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

8522 Issued in AL

Legal business name

GEORGE G. TISDALE, M.D.

Practice address

217 Broad St
Selma, AL 36701-4589

Phone

(334) 875-5000

NPI assigned

Jan 29, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. George G. Tisdale, M.D.NPI 1952410177

Title

Medical Doctor

Phone

(334) 875-5000

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• George G Tisdale, M.D.

  • MOHS-Micrographic Surgery Physician
  • Birmingham, AL
  • NPI 1952410177
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073659173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 BROAD ST",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367014589",
            "telephone_number": "334-875-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 BROAD ST",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367014589",
            "telephone_number": "334-875-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE G. TISDALE, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TISDALE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "334-875-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AL",
            "license": "8522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordon M. Forward, LCSW
• Mary Beth Frazer, MCD, CCC-SLP
• Walid Wajih Freij, M.D.
• Tina Fulford
• Cecil William Fuller Sr., DMD
• Kellyn Moore Gibson, OTR/L
• Dana Sheree Gill, PHARM.D
• Tyler Dean Goins, M.D.
• Brian Richard Gosa, PHARM,D.
• Catrena Yolanda Gray

• MOHS-Micrographic Surgery Physician in Selma, AL
• Providers in Selma, AL by specialty
• MOHS-Micrographic Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.