Individual
DR. RICHARD H TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2485 N MAIN ST, JAY, OK 74346-0987
(918) 253-2550
(918) 253-2122
Mailing address
PO BOX 987, 2485 N MAIN ST, JAY, OK 74346-0987
(918) 253-2550
(918) 253-2122
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18708
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100102630F
—
OK
05
—
200134610A
—
OK
01
—
201190171
TRI CARE
OK
Enumeration date
05/03/2006
Last updated
01/20/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us