Tidwell, Stephen Craig
Tidwell, Stephen Craig is an individual health care provider with primary practice located at 1105 Burleyson Rd , Dalton GA 30720-3017. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Tidwell, Stephen Craig can be contacted via phone (706) 278-4640.Contact Information
Primary practice address
1105 Burleyson Rd
Dalton GA 30720-3017
Phone: (706) 278-4640
Fax: (706) 275-6599
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 046332 | Georgia |
Profile Details
| NPI number | 1326149683 |
|---|---|
| LBN Legal business name | Tidwell, Stephen Craig |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 26th, 2006 |
| Last updated | Oct 11th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326149683 | NPPES |
| Georgia | MEDICAID | 00812743A |
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