Organization
DOCTORS MEMORIAL HOSPITAL INC
Active
Other names
DMH Physicians Group
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN TIDWELL (CLINIC MANAGER)
(850) 223-5409
Entity
Organization
Contact information
Practice address
333 N BYRON BUTLER PKWY, PERRY, FL 32347-2300
(850) 584-0860
Mailing address
333 N BYRON BUTLER PKWY, PERRY, FL 32347-2300
(850) 584-8404
(850) 584-3885
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23466W
BCBS
—
01
—
24274
BCBS
—
05
—
250953900
—
FL
05
—
252009500
—
FL
05
—
275448700
—
FL
05
—
275738900
—
FL
05
—
279528100
—
FL
01
—
36645
BCBS
—
05
—
374283100
—
FL
01
—
41469B
BCBS
—
01
—
53900
BCBS
—
Enumeration date
11/22/2006
Last updated
12/14/2022
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