Individual
DR. SERENA DAVIS TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1538 13TH AVE, SUITE C 200, COLUMBUS, GA 31901-1956
(706) 320-2547
(706) 320-2549
Mailing address
1538 13TH AVE, SUITE C 200, COLUMBUS, GA 31901-1956
(706) 320-2547
(706) 320-2549
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
051192
GA
Other
Enumeration date
07/07/2006
Last updated
03/17/2011
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