Most Relevant Information
Provider Data
| NPI Number: | 1003420647 |
| Provider Name: | WELDON TISDALE |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/01/2020 |
| Last Updated: | 09/01/2020 |
Provider Practice Location
3606 N MLK JR BLVD
TULSA
OK
741066447
Practice Location Phone/Fax
| Phone: | 9189494212 |
| Fax: | 9189494299 |
Provider Mailing Location
3606 N MLK JR BLVD
TULSA
OK
741066447
Provider Mailing Phone/Fax
| Phone: | 9189494212 |
| Fax: | 9189494299 |