Richard H Tidwell MD Pllc

NPI #1366589608 in Jay, Oklahoma

Provider Information

NPI Number: 1366589608
Entity Type: Organization
Organization Name: Richard H Tidwell MD Pllc
Primary Specialty: Family Medicine
Enumeration Date: Jan 30, 2007
Last Updated: Apr 20, 2008

Practice Location

Address: 2485 N MAIN STREET
City: Jay
State: Oklahoma
ZIP Code: 74346-0987
Phone: (918) 253-2550

Authorized Official

Name: DR. RICHARD H TIDWELL, MD
Title: OWNER
Phone: (918) 253-2550

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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