DR. REX WALLACE TIDWELL (NPI# 1205902749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1205902749 |
Entity Type | Individual |
Full Name | DR. REX WALLACE TIDWELL |
Credential | M.D. |
Practice Address |
1601 Watson Blvd. Houston Medical Center Warner Robins GA 31093 |
Mailing Address |
11811 Ga Highway 74 Forsyth GA 31029-7409 |
Practice Telephone | 4785427996 |
Practice Fax Number | 4785427943 |
Mailing Telephone | 4789949877 |
Mailing Fax Number | 4789929362 |
Enumeration Date | 2006-11-27 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
010300 | GA | Allopathic & Osteopathic Physicians |
Street Address |
1601 WATSON BLVD. HOUSTON MEDICAL CENTER |
City | WARNER ROBINS |
State | GA |
Zip Code | 31093 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942439716 | Simpal Kaur Gill | Pathology | 1601 Watson Blvd., Sepa Labs @ Houston Medical Center, Warner Robins, GA 31093 | 2009-07-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922654102 | Hui Bostian | Technician | 402 Pinecrest Dr., Warner Robins, GA 31093 | 2019-08-14 |
1457914616 | Janvi Hemantkumar Wadiwala | Student in an Organized Health Care Education/Training Program | 233 North Houston Rd, Suite 140e, Warner Robins, GA 31093 | 2019-04-15 |
1477033124 | Urological Health Center, PC | Urology | 1770 Watson Boulevard, Warner Robins, GA 31093 | 2018-08-21 |
1477043719 | Revealing Strength Counseling, LLC | Counselor | 2762 Watson Blvd, Warner Robins, GA 31093 | 2018-05-11 |
1265930069 | Alma J Ellington | Counselor | 306 North Davis Drive, Suite B Room 4, Warner Robins, GA 31093 | 2018-01-26 |
1841707668 | Guiding Light Healthcare Services | Family Medicine | 306 N. Davis Dr., Suite B, Warner Robins, GA 31093 | 2018-01-02 |
1083143416 | Rosa C Gilbert | Counselor | 303 Mimosa, Warner Robins, GA 31093 | 2017-06-08 |
1982141545 | Ariel Young | Psychologist | 104 Stanton Circle, Warner Robins, GA 31093 | 2017-01-20 |
1801259437 | Gramps 'n' Grannies, Inc. | Assisted Living Facility | 502 North Huston Rd., Warner Robins, GA 31093 | 2016-03-31 |
1710346903 | Brenda Marie Warren | Marriage & Family Therapist | 106-b Olympia Dr., Warner Robins, GA 31093 | 2016-02-16 |
Find all providers in zip 31093 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447342886 | William Barry Smith | Radiology | 11 Willow Lake Dr, Warner Robins, GA 31093-8523 | 2006-09-29 |
1801878210 | Mark H. Ivey | Radiology | 320 Margie Drive, Heart of Georgia Medical Associates, Warner Robins, GA 31088-7817 | 2005-11-19 |
1003897513 | Northwest Diagnostic Imaging, Inc | Radiology | 2706 Watson Blvd, Suite D, Warner Robins, GA 31093-2997 | 2005-11-10 |
1316394976 | Northside Imaging LLC | Radiology | 2706 Watson Blvd, Suite D, Warner Robins, GA 31093-2997 | 2016-05-24 |
1356642581 | Medical Radiology Consultants, LLC | Radiology | 1601 Watson Blvd, Warner Robins, GA 31093-3431 | 2010-11-04 |
1225260664 | Open Mri of Georgia, Inc | Radiology | 2706 Watson Blvd, Suite D, Warner Robins, GA 31093-2997 | 2009-08-19 |
1083854343 | Ava Ann Powell | Radiology | 1601 Watson Blvd, Attn: Radiology Department, Warner Robins, GA 31093-3431 | 2009-02-26 |
1336332295 | Rebecca Beasley | Radiology | 1601 Watson Blvd, Warner Robins, GA 31093-3431 | 2007-08-23 |
1306049325 | Atif Iqbal Rana | Radiology | 1601 Watson Blvd, Warner Robins, GA 31093-3431 | 2007-06-07 |
1003841875 | Noman Ahmed Malik | Radiology | 1601 Watson Blvd, Houston Medical Center, Attn: Radiology Dept, Warner Robins, GA 31093-3431 | 2006-07-11 |
Find all providers in WARNER ROBINS |
City | WARNER ROBINS |
Zip Code | 31093 |
Please comment or provide details below to improve the information on DR. REX WALLACE TIDWELL.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.