Thompson W. Tisdale Jr., PA-C

Individual provider Active NPI Physician Assistant · Hickory, NC

NPI 1285699520 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1285699520
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
100255 (NC)
Practice address
1781 Tate Blvd SE
Suite 201
Hickory, NC 28602-4233
Phone
(828) 322-3725
Fax
(828) 322-2389
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Graystone Ear, Nose and Throat Associates, PA Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 100255 NC Yes

Addresses

Primary practice location

1781 Tate Blvd SE
Suite 201
Hickory, NC 28602-4233

Mailing address

1781 Tate Blvd SE
Suite 201
Hickory, NC 28602-4233
Phone (828) 322-3725

Other providers in Hickory, NC

All providers in Hickory, NC · Physician Assistant in North Carolina

Sources for this page

Verify at the official NPI Registry.