Home » Oklahoma » 74346 » Richard H Tidwell Md Pllc

Richard H Tidwell Md Pllc

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.

physician-icon Basic Information

Practice Location 2485 N Main Street, Jay, OK 74346-0987, US
Practice Location Phone918-253-2550
Practice Location Fax918-253-2559
Legal Business NameRICHARD H TIDWELL MD PLLC
Other Organization NameJAY FAMILY MEDICINE CLINIC
Other Organization Name TypeDoing Business As Name
NPI ?1366589608
Entity TypeOrganization
Enumeration Date ? Jan 30, 2007
Last Update Date ? Apr 20, 2008
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Richard H Tidwell Md Pllc

SpecialtySpecializationLicenseLicense State
Family Medicine 18708Oklahoma

legacy-id-icon Legacy Provider IDs of Richard H Tidwell Md Pllc

Provider IdIssuer StateIssuer TypeIssuer
442760537004OklahomaOtherBLUE CROSS BLUE SHIELD
=========OklahomaOtherTAX ID
=========OklahomaOtherTRICARE

official-icon Authorized Official of Richard H Tidwell Md Pllc

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/PositionOWNER
Authorized Official Phone Number918-253-2550