Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. THOMAS JACKSON TIDWELL, M.D.
Active Sole ProprietorRadiation Oncology Clinic · COLUMBUS, GA
Registration Details
- NPI Number
- 1578658670
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 4, 2006 (19.549631770426 yrs)
- Last Updated
- Oct 16, 2009
- License
-
18964 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2121 WARM SPRINGS RD STE BCOLUMBUS, GA, 319047954Browse GA providers · Browse ZIP 31904
- Phone
- 7066608121
- Fax
- 7063234205
- Primary Specialty
-
Radiation Oncology Clinic
261QX0203X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.