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Individual

DR. PATRICE TALLEY BIDWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2010 FLEISCHMANN RD, TALLAHASSEE, FL 32308-4599
(850) 552-0608
(850) 552-0925
Mailing address
PO BOX 919030, ORLANDO, FL 32891-9030
(850) 656-4277
(850) 656-4276

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME47516
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME47516
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
37487
BLUE CROSS
FL
Enumeration date
02/02/2006
Last updated
10/11/2007
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