Dr Detra Michelle Tisdale, MD - Internal Medicine in Cordova, TN

Dr Detra Michelle Tisdale, MD is a Internal Medicine physician based in Cordova, Tennessee. Dr Detra Michelle Tisdale is licensed to practice in Tennessee (license number 46435) and her current practice location is 1144 N Houston Levee Rd, Suite 102, Cordova, Tennessee. She can be reached at her office (for appointments etc.) via phone at (901) 382-2044.

NPI number for Dr Detra Michelle Tisdale is 1730273079 and her current mailing address is 1144 N Houston Levee Rd, Suite 102, Cordova, Tennessee. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1730273079.

Contact Information

Dr Detra Michelle Tisdale, MD
1144 N Houston Levee Rd, Suite 102,
Cordova, TN 38018-7145
(901) 382-2044
Not Available



Physician's Profile

Full NameDr Detra Michelle Tisdale
GenderFemale
SpecialityInternal Medicine
Location1144 N Houston Levee Rd, Cordova, Tennessee
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1730273079
  • Provider Enumeration Date: 10/03/2006
  • Last Update Date: 12/06/2010

Medical Identifiers

Medical identifiers for Dr Detra Michelle Tisdale such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1730273079NPI-NPPES
06837219MedicaidMS
1369047MedicaidLA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 053713 (Georgia)Secondary
207R00000XInternal Medicine MD202661 (Louisiana)Secondary
207R00000XInternal Medicine 46435 (Tennessee)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. Dr Detra Michelle 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 AddressPractice Location Address
Dr Detra Michelle Tisdale, MD
1144 N Houston Levee Rd, Suite 102,
Cordova, TN 38018-7145

Ph: () -
Dr Detra Michelle Tisdale, MD
1144 N Houston Levee Rd, Suite 102,
Cordova, TN 38018-7145

Ph: (901) 382-2044

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Internal Medicine Doctors in Cordova, TN

Dr. Gary David Strasberg, M.D.
Internal Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 2551 Ashburton Pl N, Cordova, TN 38016
Phone: 901-275-4922    
Gregory K Jenkins, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 8138 Country Village Dr, Cordova, TN 38016
Phone: 901-260-3100    Fax: 901-755-1113
Dr. Catherine Mulroy Munn, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 8138 Country Village Dr, Cordova, TN 38016
Phone: 901-260-3100    Fax: 901-755-1113
Dr. Sandra W Cohen, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 57 Germantown Ct, Suite 100, Cordova, TN 38018
Phone: 901-758-7888    Fax: 901-266-6445
Charles R Arkin, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 540 Trinity Creek Cv, Cordova, TN 38018
Phone: 901-309-5000    Fax: 901-309-5008
Dr. John M Bills Jr., MD
Internal Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 1660 Bonnie Ln Ste 105, Cordova, TN 38016
Phone: 901-888-1000    
Dr. Frank John Adcock Iii, MD
Internal Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 8596 Rockcreek Pkwy, Cordova, TN 38016
Phone: 901-372-4350    Fax: 901-372-4350

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