Hollis Tidmore (NPI# 1962473975, PAC ID# 3971536343) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL PRACTICE.
| Nation Provider ID (NPI) | 1962473975 |
| PAC ID by PECOS | 3971536343 |
| Professional Enrollment ID | I20090511000085 |
| Full Name | Hollis Tidmore |
| Address |
1226 Linn St Suite B Sikeston MO 63801-5200 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE |
| Graduation Year | 1980 |
| Primary Specialty | GENERAL PRACTICE |
| Secondary Specialties | VASCULAR SURGERY |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260113 | MISSOURI DELTA MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1226 Linn St, Suite B, Sikeston, MO 63801-5200 |
| Street Address |
1226 LINN ST SUITE B |
| City | SIKESTON |
| State | MO |
| Zip | 63801-5200 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Blake A Borders | Nurse Practitioner | Managed Care Inc | 808 Hunter Ave, Suite 4, Sikeston, MO 63801-2253 |
| Melinda G Lambert | Nurse Practitioner | Managed Care Inc | 808 Hunter Ave, Suite 4, Sikeston, MO 63801-2253 |
| Kenneth W Rubenacker | Qualified Audiologist | 417 B S Kingshighway St, Area Hearing Services, Sikeston, MO 63801-2923 | |
| Leslie S Winchester | Chiropractic | Winchester Chiropractic and Wellness PC | 521 Greer Ave, Sikeston, MO 63801-3023 |
| Jack C Mills | Chiropractic | 1222 Linn St, Sikeston, MO 63801-3402 | |
| Brett E Taylor | Chiropractic | 1222 Linn St, Sikeston, MO 63801-3402 | |
| Danielle Elizabeth Jansen | Nurse Practitioner | Southeast Missouri Health Network | 200 Southland Dr, Sikeston, MO 63801-4403 |
| Daniel G Domjan | Family Medicine | Southeast Missouri Health Network | 200 Southland Dr, Sikeston, MO 63801-4403 |
| Rebecca Vanessa Young | Nurse Practitioner | Southeast Missouri Health Network | 200 Southland Dr, Sikeston, MO 63801-4403 |
| William B Bradley | Nurse Practitioner | Southeast Missouri Health Network | 200 Southland Dr, Sikeston, MO 63801-4403 |
| Find all physicians in zip 63801 | |||
| City | SIKESTON |
| Zip Code | 63801 |
| Specialty | GENERAL PRACTICE |
| City + Specialty | SIKESTON + GENERAL PRACTICE |
Please comment or provide details below to improve the information on Hollis Tidmore.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.