Brett B Tisdale (NPI# 1699754572, PAC ID# 0941205041) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1699754572 |
| PAC ID by PECOS | 0941205041 |
| Professional Enrollment ID | I20090623000239 |
| Full Name | Brett B Tisdale |
| Organization Legal Name | STATCARE PLLC |
| Address |
1015 Delaware Ave Suite C Mccomb MS 39648-3827 |
| Phone Number | 6012494777 |
| Gender | M |
| Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS |
| Graduation Year | 1993 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 5799764965 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250097 | SOUTHWEST MS REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1015 Delaware Ave, Suite C, Mccomb, MS 39648-3827 | 6012494777 | STATCARE PLLC |
| 1017 Delaware Ave, Mccomb, MS 39648-3827 | 6012501122 | STATCARE PLLC |
| Organization Legal Name | STATCARE PLLC |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melanie Robertson | Nurse Practitioner | Statcare Pllc | 1015 Delaware Ave, Suite C, Mccomb, MS 39648-3827 |
| Jodi L Waller | Nurse Practitioner | Statcare Pllc | 105 S Laurel St, Suite A, Summit, MS 39666-9349 |
| Jackie E Brister | Nurse Practitioner | Statcare Pllc | 1015 Delaware Ave, Suite C, Mccomb, MS 39648-3827 |
| Christopher Bracey | Nurse Practitioner | Statcare Pllc | 1015 Delaware Ave, Suite C, Mccomb, MS 39648-3827 |
| Darryl G Temple | Nurse Practitioner | Statcare Pllc | 1015 Delaware Ave, Suite C, Mccomb, MS 39648-3827 |
| John A Watson | Emergency Medicine | Statcare Pllc | 1015 Delaware Ave, Suite C, Mccomb, MS 39648-3827 |
| John N Harvey | Nurse Practitioner | Statcare Pllc | 1015 Delaware Ave, Suite C, Mccomb, MS 39648-3827 |
| Street Address |
1015 DELAWARE AVE SUITE C |
| City | MCCOMB |
| State | MS |
| Zip | 39648-3827 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melanie Robertson | Nurse Practitioner | Statcare Pllc | 1015 Delaware Ave, Suite C, Mccomb, MS 39648-3827 |
| Jackie E Brister | Nurse Practitioner | Statcare Pllc | 1015 Delaware Ave, Suite C, Mccomb, MS 39648-3827 |
| Christopher Bracey | Nurse Practitioner | Statcare Pllc | 1015 Delaware Ave, Suite C, Mccomb, MS 39648-3827 |
| Darryl G Temple | Nurse Practitioner | Statcare Pllc | 1015 Delaware Ave, Suite C, Mccomb, MS 39648-3827 |
| John A Watson | Emergency Medicine | Statcare Pllc | 1015 Delaware Ave, Suite C, Mccomb, MS 39648-3827 |
| John N Harvey | Nurse Practitioner | Statcare Pllc | 1015 Delaware Ave, Suite C, Mccomb, MS 39648-3827 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David Scott Snow | Family Medicine | 1121 Hwy 98/51, Summit, MS 39648 | |
| Damon S Spears | Nurse Practitioner | Maxem Health Urgent Care Mccomb | 101 Edgewood Dr, Mccomb, MS 39648-2043 |
| Tonya Brister | Nurse Practitioner | Maxem Health Urgent Care Mccomb | 101 Edgewood Dr, Mccomb, MS 39648-2043 |
| James Stephen Moore | Optometry | 1722 Veterans Blvd, C2, Mccomb, MS 39648-2052 | |
| Kimberly F Harrell | Optometry | 1608 Veterans Blvd, Mccomb, MS 39648-2064 | |
| Kappi F Rushing | Nurse Practitioner | Mccomb Og-gyn Associated | 205 Marion Ave, Mccomb, MS 39648-2705 |
| Ashraf E Riad | Anesthesiology | Mccomb Anesthesia Associates, LLP | 215 Marion Ave, Mccomb, MS 39648-2705 |
| Carl R Feind | Interventional Cardiology | Southwest Mississippi Regional Medical Center | 215 Marion Ave, Mccomb, MS 39648-2705 |
| Warren J Anderson | Certified Registered Nurse Anesthetist (crna) | Mccomb Anesthesia Associates, LLP | 215 Marion Ave, Mccomb, MS 39648-2705 |
| Dany Haddad | Internal Medicine | Southwest Mississippi Regional Medical Center | 215 Marion Ave, Mccomb, MS 39648-2705 |
| Find all physicians in zip 39648 | |||
| City | MCCOMB |
| Zip Code | 39648 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | MCCOMB + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Brett B Tisdale.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.