Richard H Tidwell Md Pllc is a health care provider in Jay, OK. In this page you will find its mailing address, practice location, phone number, specialty etc.
|Practice Location||2485 N Main Street, Jay, OK 74346-0987, US|
|Practice Location Phone||918-253-2550|
|Practice Location Fax||918-253-2559|
|Legal Business Name||RICHARD H TIDWELL MD PLLC|
|Other Organization Name||JAY FAMILY MEDICINE CLINIC|
|Other Organization Name Type||Doing Business As Name|
|Enumeration Date ?||Jan 30, 2007|
|Last Update Date ?||Apr 20, 2008|
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).
|Specialty||Provider Type||Specialization||License||License State|
|Family Medicine||Allopathic & Osteopathic Physicians||18708||Oklahoma|
|Provider Id||Issuer State||Issuer Type||Issuer|
|442760537004||Oklahoma||Other||BLUE CROSS BLUE SHIELD|
An authorized official is an appointed official with the legal authority to make changes and/or updates to the Richard H Tidwell Md Pllc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).
|Authorized Official||Dr. Richard H Tidwell (MD)|
|Authorized Official Title/Position||OWNER|
|Authorized Official Phone Number||918-253-2550|