Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KENNETH DORSEY TISDALE, L.C.I.C.I., LMT #548
Active Sole ProprietorKENNETH DORSEY TISDALE, L.C.I.C.I., LMT #548 is a Contractor healthcare provider located in ALBUQUERQUE, New Mexico. NPI 1962709956 is currently active in the NPPES registry. Verify at CMS.
Contractor · ALBUQUERQUE, NM
Registration Details
- NPI Number
- 1962709956
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 28, 2011 (15.461735731972 yrs)
- Last Updated
- Feb 28, 2011
- License
-
LMT # 5488 (NM)
- Sole Proprietor
- Yes
Practice Information
- Address
-
201 EUBANK BLVD NEB1ALBUQUERQUE, NM, 87123Browse NM providers · Browse ZIP 87123
- Phone
- 5057127585
- Primary Specialty
-
Contractor
171W00000X
Other Contractor Providers in ALBUQUERQUE, NM
| Name | Credential | NPI |
|---|---|---|
| MR. MARTIN D BINDER | ATC | 1104842525 |
| RITA WORMWOOD | — | 1891843264 |
| CHERYL L KIRK-MCMULLEN | OTR | 1932234085 |
| DONNA A KOTILAINEN | P.T. | 1538281720 |
| MS. TAMARA ROSE MARTINEZ | LMT | 1013122290 |
| KURT SIMMONS | — | 1407062938 |
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.