John Scott Tidball, M.D.

NPI #1760580476 in California, Maryland

Provider Information

NPI Number: 1760580476
Entity Type: Individual
Name: John Scott Tidball, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: M.D.
Enumeration Date: Sep 20, 2006
Last Updated: Apr 18, 2011

Practice Location

Address: 23415 THREE NOTCH RD
Address 2: SUITE 2054 WILDEWOOD CENTER
City: California
State: Maryland
ZIP Code: 20619-4017
Phone: (301) 737-7833

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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Organizations

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