Provider Demographics
NPI:1366429151
Name:TISHLER, STEVEN D (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:D
Last Name:TISHLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:210 25TH AVE N STE 1204
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1620
Mailing Address - Country:US
Mailing Address - Phone:615-312-0600
Mailing Address - Fax:615-320-3259
Practice Address - Street 1:2006 FRANKLIN ST SE STE 200
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4537
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:256-539-5827
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN256832085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1366429151OtherTRICARE
TN6450426OtherBCBS TN
AL6845839OtherCIGNA
AL305049Medicaid
KY64037757Medicaid
AL307305Medicaid
TN3083251OtherTSC
TN3083255Medicaid
AL306967Medicaid
TN3083255OtherTNONC
AL306681Medicaid
AL306971Medicaid
AL307209Medicaid
TN1509194OtherIANP
AL306269Medicaid