SERENA D. TIDWELL, M.D., P.C.
Managed Care Organizations at 13 Ave, Columbus, GA

License number
Georgia 051192
Category
Managed Care Organizations
Type
Point of Service
Owner
Name: DR. SERENA DAVIS TIDWELL M.D.
Title: PRESIDENT
Phone: (706) 320-2547
Address
Address
1538 13Th Ave SUITE C200, Columbus, GA 31901
National Provider ID: 1689759581
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SERENA D. TIDWELL, M.D., PC

1538 13 Ave SUITE C200, Columbus, GA 31901

Industry:
Medical Doctor's Office
Doing business as:
Serena D Tidwell MD PC
Registration:
Dec 31, 2002
State ID:
0300943
Business type:
Domestic Professional Corporation
Medical Doctors:
D. Serena Tidwell (CFO), 6924 Gaines Rdg Rd, Columbus, GA 31904 (Physical),Serena D. Tidwell (Medical Doctor, Member, President),Christopher K. Tidwell (Medical Doctor)
Agent:
Carl A. Rhodes,1601 13 St, Columbus, GA (Physical)

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