William C Tidmore JR. M.D.

NPI 1073695292 - Internal Medicine - 207RR0500X

NPI Details
NPI 1073695292
Gender Male
Enumeration Date 10/19/2006
Last Updated 09/23/2013
Entity Type Individual
Active Over 10 years ago
Practice Location
2418 N OAK ST
VALDOSTA GA, 31602-2576, US
Phone (229) 219-0247
Fax (229) 219-0837
Business Location
2418 N OAK ST
VALDOSTA GA, 31602-2576, US
Phone (229) 219-0247
Fax (229) 219-0837
Toxanomy
Taxonomy Code 207RR0500X
License State Georgia
License Number 041978
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According to our database, Dr. William C Tidmore JR. M.D. NPI is 1073695292, taxonomy code is 207RR0500X and license number is 041978, license state is located at Georgia. William C Tidmore JR. M.D. physically located at 2418 N Oak St, Valdosta GA, 31602-2576. NPI Number William C Tidmore JR. M.D. has the Individual type.

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1073695292 NPI number is provided on an as is basis without warranty of any kind. 1073695292 is maintained by the National Plan & Provider Enumeration System. The contents of William C Tidmore JR. M.D. are for informational purposes only.