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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

CHARLES GIRARD TISDALE, PA-C

Active

CHARLES GIRARD TISDALE, PA-C is a Surgical Physician Assistant healthcare provider located in SHREVEPORT, Louisiana. NPI 1821096686 is currently active in the NPPES registry. Verify at CMS.

Surgical Physician Assistant · SHREVEPORT, LA

Registration Details

NPI Number
1821096686
Provider Type
Individual
Gender
Male
NPI Issued
Jul 14, 2005 (21.04656601894 yrs)
Last Updated
Nov 24, 2025
Licenses
A10284 (LA)
PA.A10284 (LA)

Practice Information

Address
1500 LINE AVE STE 100
SHREVEPORT, LA, 711014644
Browse LA providers · Browse ZIP 71101
Phone
3186353052
Primary Specialty
Surgical Physician Assistant
363AS0400X
Additional Specialty
Surgical Physician Assistant

Other Surgical Physician Assistant Providers in SHREVEPORT, LA

Name Credential NPI
SHERRY B WALKER PA 1669442133
PAUL BRYANT MCHALFFEY PA-C 1720041312
STAFFORD R LONG PA-C 1851343396
MARY EMILY MAY 1528082781
MS. MARIBETH FORREST P.A.-C 1235220708
SCOTT R GILLUM PA 1114003076
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.