LESLIE G TIDWELL

MACON, GA
NPI1568419216
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: GA  44359)
Additional Taxonomies207V00000X Obstetrics & Gynecology
(Licence: GA  44359)
Enumeration Date2006-05-28
Last Update Date2018-03-17
Business Address
LESLIE G TIDWELL MD
3448 VINEVILLE AVE
MACON, GA 31204-1867
Phone number: 478-405-0045
Mailing Address
LESLIE G TIDWELL MD
3448 VINEVILLE AVE
MACON, GA 31204-1867
Phone number: 478-405-0045