Dale Roger Tidaback in Wright Patterson Afb - Family Medicine
Dale Roger Tidaback - NPI 1710963772
Dale Roger Tidaback is a Family Medicine in Wright Patterson Afb, Ohio. Dale Roger Tidaback practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Dale Roger Tidaback is 1710963772. The last update date is 2014-12-02.
Dale Roger Tidaback's current location address is 4881 Sugar Maple Dr, Wright Patterson Afb, Ohio. You can contact this provider via phone number 7039948148. The mailing address for Dale Roger Tidaback is 4881 Sugar Maple Dr, Wright Patterson Afb, Ohio. To know further, please read the information below!
Provider Profile Detail
Provider Name | Dale Roger Tidaback |
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Address | 4881 Sugar Maple Dr, Wright Patterson Afb, Ohio |
Phone Number | 7039948148 |
Fax Number | |
Sole Proprietor | Y |
Credentials | MD, MPH |
NPI Number Detail
NPI Number | 1710963772 |
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Provider Enumeration Date | 2005-12-21 |
Last Updated Date | 2014-12-02 |
Provider Mailing Address Detail
Address | 4881 Sugar Maple Dr |
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City | Wright Patterson Afb |
State | Ohio (OH) |
Post Code | 454335529 |
Phone Number | 7039948148 |
Fax Number |
Provider's Primary Taxonomy Detail
Speciality | Family Medicine |
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Taxonomy | 207Q00000X |
Licence No | 1559 |
Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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What is the Dale Roger Tidaback's unique identification number?
The Dale Roger Tidaback has been assigned the NPI (National Provider Identifier) Number 1710963772 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical location address where Dale Roger Tidaback's facilities are situated?
The facilities of Dale Roger Tidaback are physically located at the following address: 4881 Sugar Maple Dr, Wright Patterson Afb, OH, 454335529.
What is Dale Roger Tidaback's specialized field of practice, and what is the corresponding taxonomy classification code?
The Dale Roger Tidaback's area of specialization is Family Medicine, and the corresponding taxonomy code that categorizes this field of practice is 207Q00000X.
When was the Dale Roger Tidaback's 1710963772 issued?
The Dale Roger Tidaback's 1710963772 was issued on 2005-12-21.
When was the information regarding Dale Roger Tidaback most recently updated?
The details pertaining to the Dale Roger Tidaback, including its address, specialty, and other relevant information, were last refreshed on 2014-12-02.
NPI Number: 1720081763
Address: 675 E Highway 60, Hardinsburg, KY