National Provider Identifier

Britton Edgett Tisdale, M.D., B.SC.PHM.

Britton Edgett Tisdale, M.D., B.SC.PHM. is listed in the NPPES registry with a primary specialty of Urology Physician in Amherst, NY and a listed phone number of (716) 319-8113.

NPI 1679888606Amherst, NYUrology Physician

Profile Overview

NPI
1679888606
Provider Type
Individual
Primary Specialty
Urology Physician
Enumeration Date
August 14, 2010
Last Updated
April 08, 2025

Practice Location

  • 36 Nature Cove Ct
  • Amherst, NY 14221-1978

Phone: (716) 319-8113

Mailing Address

  • 180 Vine Street South
  • Suite 202
  • St. Catharines, Ontario 273
  • CA

Specialties

  • Urology Physician (208800000X)
  • Urology Physician (208800000X)
Full Record
NPI
1679888606
Entity Type
Individual
Last Name
Tisdale
First Name
Britton
Middle Name
Edgett
Name Prefix
Dr.
Credential
M.D., B.SC.PHM.
Mailing Street Address
180 Vine Street South
Mailing Address Line 2
Suite 202
Mailing City
St. Catharines
Mailing State
Ontario
Mailing ZIP Code
273
Mailing Country
CA
Practice Street Address
36 Nature Cove Ct
Practice City
Amherst
Practice State
NY
Practice ZIP Code
14221-1978
Practice Country
US
Practice Phone
(716) 319-8113
Enumeration Date
August 14, 2010
Last Updated
April 08, 2025
Sex
Male
Sole Proprietor
Yes
Certification Date
April 08, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Urology Physician (208800000X), Urology Physician (208800000X)
Other Identifiers
3383479 (NY), 533379001 (NY, Blue Cross), 29695201 (NY, Univera), 652569 (NY, Wellcare), 1916947 (NY, Iha)