SERENA D. TIDWELL M.D. P.C. NPI 1689759581

NPI Information

SERENA D. TIDWELL, M.D., P.C. is a point of service in Columbus, GA. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. SERENA D. TIDWELL, M.D., P.C. NPI is 1689759581. The provider is registered as an organization entity type.
The provider Is Doing Business As Midtown Ob Gyn.

The provider's business location address is:

1538 13TH AVE
SUITE C200
COLUMBUS, GA
ZIP 31901-956
Phone: (706) 320-2547
Fax: (706) 320-2549

The provider's authorized official is Serena Davis Tidwell .
The authorized official title is President and has the following contact phone number (706) 320-2547.

The CLIA number assigned to this NPI record is 11D2161000 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/26/2006 and was last updated on 1/20/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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