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

Dr. Ronald Coury Tisdale, MD

Individual provider Professional Counselor · NPI 1790203461

Dr. Ronald Coury Tisdale, MD is a Family Practice in Selma, Alabama. Graduated from Icahn School of Medicine at Mount Sinai in 2017, 9 years ago. Practices with Paragon Contracting Services LLC, a 395-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Alabama.

Years since qualifying
9
Trained at
Icahn School of Medicine at Mount Sinai
Licensed in
AL
In the registry since
2017
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1023 Medical Center Pkwy
Selma, AL 36701-6750
Phone: (650) 387-2272
Show map & directions

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

Additional practice locations (3)

  • 300 Pasteur Dr, Stanford, CA 94305-2200 — (650) 387-2272
  • 1 Gustave L Levy Pl, New York, NY 10029-6504 — (650) 387-2272
  • 29360 Belmont Lake Rd, Perrysburg, OH 43551-3760 — (650) 387-2272

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD.41401 (AL)
Professional Counselor Taxonomy 101YP2500X
Emergency Medicine Physician Taxonomy 207P00000X · Licence MD.41401 (AL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1790203461
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 1, 2017
Last updated in NPPESSeptember 2, 2020
Certification dateSeptember 2, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Graduated 2017 (9 years in practice)
Group practice Paragon Contracting Services Llc — 395 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Selma