Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Detra Michelle Tisdale, MD

Individual provider Internal Medicine Physician · NPI 1730273079

Dr. Detra Michelle Tisdale, MD is an Internal Medicine Physician in Cordova, Tennessee. Licensed in Georgia, Louisiana and Tennessee. Registered with an NPI since 2006.

Licensed in
GA, LA, TN
In the registry since
2006
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1144 N Houston Levee Rd Ste 102
Cordova, TN 38018-7145
Phone: (901) 382-2044
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 46435 (TN)
Internal Medicine Physician Taxonomy 207R00000X · Licence 053713 (GA)
Internal Medicine Physician Taxonomy 207R00000X · Licence MD202661 (LA)

Record details

NPI number1730273079
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 3, 2006
Last updated in NPPESDecember 6, 2010

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