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

John R Tisdale, MD

Individual provider Pediatrics Physician · NPI 1649414525

John R Tisdale, MD is an Internal Medicine in Little Rock, Arkansas. Qualified in 2009, 17 years ago. Practices with University of Arkansas for Medical Sciences, a 1,144-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arkansas and Ohio.

Years since qualifying
17
Licensed in
AR, OH
In the registry since
2009
Specialties on file
4
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

1811 Rahling Rd Ste 120
Little Rock, AR 72223-4678
Phone: (501) 214-2360
Fax: (501) 214-2356
Show map & directions

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

Additional practice locations (1)

  • Highway 191 And Hospital Road, Chinle, AZ 86503 — (928) 674-7166

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence E-18802 (AR)
Pediatrics Physician Taxonomy 208000000X · Licence E-18802 (AR)
Pediatrics Physician Taxonomy 208000000X · Licence 35.121001 (OH)
Internal Medicine Physician Taxonomy 207R00000X · Licence 35.121001 (OH)

Record details

NPI number1649414525
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 23, 2009
Last updated in NPPESDecember 4, 2025
Certification dateDecember 4, 2025

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice University Of Arkansas For Medical Sciences — 1144 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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