DR. HOLLIS TIDMORE (NPI# 1962473975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962473975 |
Entity Type | Individual |
Full Name | DR. HOLLIS TIDMORE |
Credential | MD |
Practice Address |
1226 Linn St Suite B Sikeston MO 63801-5200 |
Practice Telephone | 5734758599 |
Practice Fax Number | 5734758596 |
Mailing Telephone | 5734758599 |
Mailing Fax Number | 5734758596 |
Enumeration Date | 2006-01-28 |
Last Update Date | 2015-02-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208600000X | Surgery | 2009005897 | MO | Allopathic & Osteopathic Physicians |
N | 2086S0127X |
Surgery Specialization: Trauma Surgery |
2009005897 | MO | Allopathic & Osteopathic Physicians |
N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
2009005897 | MO | Allopathic & Osteopathic Physicians |
Street Address |
1226 LINN ST SUITE B |
City | SIKESTON |
State | MO |
Zip Code | 63801-5200 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396739801 | Annetta S Schwader | Nurse Practitioner | 1226 Linn St, Suite F, Sikeston, MO 63801-5200 | 2005-09-12 |
1114316080 | Lhcg Lxv, LLC | Home Health | 1226 Linn St, Suite D, Sikeston, MO 63801-5200 | 2015-01-15 |
1821486267 | Lhcg Lxv, LLC | Home Health | 1226 Linn St, Suite F, Sikeston, MO 63801-5200 | 2015-01-08 |
1093103434 | Lhcg Lxv, LLC | Home Health | 1226 Linn St, Suite D, Sikeston, MO 63801-5200 | 2015-01-08 |
1386058170 | Sikeston Surgical Specialist, LLC | Surgery | 1226 Linn St, Suite B, Sikeston, MO 63801-5200 | 2014-06-19 |
1871887646 | Sikeston Rural Health Center LLC | Clinic/Center | 1226 Linn St, Suite B, Sikeston, MO 63801-5200 | 2011-06-08 |
1386879351 | Family First Medical Center, Inc | Clinic/Center | 1226 Linn St, Suite F, Sikeston, MO 63801-5200 | 2009-05-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689285082 | Logan & Seiler Inc | Pharmacy | 102 Hospitality Drive, Suite B, Sikeston, MO 63801 | 2020-08-11 |
1992212153 | Sharaye Gilmore | Social Worker | 135 Plaza Dr Suite 102, Sikeston, MO 63801 | 2018-01-09 |
1730606385 | Megan Leann Schlosser | Occupational Therapy Assistant | Kenny Rogers Children's Center, 300 Floyd Dr., Sikeston, MO 63801 | 2017-08-24 |
1780130930 | Delta South Adult Care Center LLC | Clinic/Center | 640 Colonel George E Day Parkway, Sikeston, MO 63801 | 2016-08-28 |
1013236421 | Missouri Delta Medical Center | Clinic/Center | 1013 North Main, Sikeston, MO 63801 | 2010-05-25 |
1134361868 | Sikeston Rehab, LLC | Physical Therapy Assistant | 806 S. Kingshighway, Sikeston, MO 63801 | 2009-03-26 |
1508066978 | Paula Kaye Beck | Occupational Therapist | 2016 Oklahoma Ave, Sikeston, MO 63801 | 2007-07-23 |
1740497551 | James D West | Audiologist | 903 South Kingshighway, Sikeston, MO 63801 | 2007-05-17 |
1619190162 | Syed Muhammad Shahab Sayeed | Psychiatry & Neurology | 1008 N Main, Missouri Delta Medical Centre, Sikeston, MO 63801 | 2007-04-11 |
1629195607 | Melissa A Stewart | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 106 Dacus, Sikeston, MO 63801 | 2007-03-23 |
Find all providers in zip 63801 |
Taxonomy Code | 208600000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639139876 | Mark Shea Henderson | Surgery | 135 Plaza Dr, Suite 202, Sikeston, MO 63801-5136 | 2006-03-23 |
1386058170 | Sikeston Surgical Specialist, LLC | Surgery | 1226 Linn St, Suite B, Sikeston, MO 63801-5200 | 2014-06-19 |
1912267410 | Cesar Omar Reategui Sanchez | Surgery | 1012 N Main St, Sikeston, MO 63801-5044 | 2012-05-18 |
1235449265 | Rami Alassaad | Surgery | 1008 N Main St, Sikeston, MO 63801-5044 | 2010-10-08 |
1871684357 | Max A Heeb | Surgery | 1008 N Main St, Sikeston, MO 63801-5044 | 2006-09-27 |
1881793727 | Loring R Helfrich | Surgery | 1015 N Main St, Sikeston, MO 63801-5043 | 2006-09-21 |
1174622021 | Fred H Thornton | Surgery | 135 Plaza Dr, Sikeston, MO 63801-5136 | 2006-09-21 |
1174621379 | Kevin P Rankin | Surgery | 1015 N Main St, Sikeston, MO 63801-5043 | 2006-09-20 |
1336247527 | Boris Frohman | Surgery | 1008 N Main St, Sikeston, MO 63801-5044 | 2006-09-20 |
1750377099 | Paul F. Montany | Surgery | 1019 N Main St, Sikeston, MO 63801-5043 | 2005-09-22 |
Find all providers in SIKESTON |
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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.