Kevin Tisdale, is a
Case Manager/care Coordinator based in Washington, District Of Columbia. Kevin Tisdale is licensed to practice in * (Not Available) (license number ) and his current practice location is
4660 Martin Luther King Jr Ave Sw, Washington, District Of Columbia. He can be reached at his office (for appointments etc.) via phone at
(202) 318-0179.
NPI number for Kevin Tisdale is 1063117976 and his current mailing address is 1310 Gallatin St Nw, Washington, District Of Columbia. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1063117976.
Healthcare Provider's Profile
| Full Name | Kevin Tisdale |
|---|
| Gender | Male |
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| Speciality | Case Manager/care Coordinator |
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| Location | 4660 Martin Luther King Jr Ave Sw, Washington, District Of Columbia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1063117976
- Provider Enumeration Date: 03/31/2023
- Last Update Date: 06/14/2023
Medical Identifiers
Medical identifiers for Kevin Tisdale such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1063117976 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kevin Tisdale is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kevin Tisdale,
1310 Gallatin St Nw,
Washington, DC 20011-6918
Ph: (202) 621-4239 | Kevin Tisdale,
4660 Martin Luther King Jr Ave Sw,
Washington, DC 20032-4933
Ph: (202) 318-0179 |
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