Individual
DR. JOHN DELMAR SIDDENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
104 SIMPSON STREET, GREENVILLE, SC 29605-3593
(864) 522-3900
(864) 522-3909
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
291
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180018447
MEDICARE RAILROAD
SC
01
—
2556148003
CIGNA PROVIDER NUMBER
SC
01
—
4232647
AETNA PROVIDER NUMBER
SC
05
—
TL0727
—
SC
Enumeration date
01/25/2006
Last updated
05/12/2021
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