Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. DALE ROGER TIDABACK, MD, MPH
Active Sole ProprietorDR. DALE ROGER TIDABACK, MD, MPH is a 2083A0100X healthcare provider located in WRIGHT PATTERSON AFB, Ohio. NPI 1710963772 is currently active in the NPPES registry. Verify at CMS.
2083A0100X · WRIGHT PATTERSON AFB, OH
Registration Details
- NPI Number
- 1710963772
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 21, 2005 (20.60678348282 yrs)
- Last Updated
- Dec 2, 2014
- Licenses
-
1559 (SD)1559 (SD)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4881 SUGAR MAPLE DRWRIGHT PATTERSON AFB, OH, 454335529Browse OH providers · Browse ZIP 45433
- Phone
- 7039948148
- Primary Specialty
-
2083A0100X
2083A0100X
- Additional Specialty
- 2083A0100X
Other 2083A0100X Providers in WRIGHT PATTERSON AFB, OH
| Name | Credential | NPI |
|---|---|---|
| DR. MAXIMILIAN SAMUEL LEE | MD | 1962494484 |
| DR. MARK R. COAKWELL | M.D., M.P.H. | 1871588327 |
| DR. STACEY LYNN BRANCH | DO, MPH | 1417942095 |
| DR. STEVEN LINDSAY BARNES | M.D., M.P.H. | 1023004868 |
| DR. ALDEN DOUGLAS HILTON SR. | M.D., M.P.H. | 1689651499 |
| DR. CHARLES DARNALL CLINTON | M.D., M.P.H. | 1619943933 |
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.