Jay Family Medicine Clinic

LBN: Richard H Tidwell Md Pllc
Jay Family Medicine Clinic is an health care organization with primary practice located at 2485 N Main Street , Jay OK 74346-0987. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Richard H Tidwell Md Pllc can be contacted via phone (918) 253-2550, or through Tidwell, Richard H via phone (918) 253-2550.

Contact Information

Primary practice address
2485 N Main Street Jay OK 74346-0987
Phone: (918) 253-2550
Fax: (918) 253-2559
Website:
Map and Directions
Authorized official contact:
Name: Tidwell, Richard H Doctor of Medicine (MD)
Phone: (918) 253-2550

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 18708 Oklahoma

Profile Details

NPI number 1366589608
LBN Legal business name Richard H Tidwell Md Pllc
DBA Doing business as Jay Family Medicine Clinic
Authorized official Tidwell, Richard H Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 30th, 2007
Last updated Apr 20th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366589608 NPPES
Oklahoma Other 442760537004 BLUE CROSS BLUE SHIELD

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