OrganizationActive
Pat T. Tidwell MD PA
NPI 1093086563 · Family Medicine Physician · Niceville, FL
Provider details
- NPI number
- 1093086563
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Pat Tidwell, President(850) 678-6735
- License
- ME30890 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Ambulatory Health Care Facilities
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4554 Highway 20 East
Niceville, FL 32578
Phone: (850) 678-6735
Fax: (850) 678-8078
Street-level locationGet directions
Mailing address
4554 Highway 20 East
Niceville, FL 32578
Registry dates
- Enumerated
- 2012-01-16
- Last updated
- 2018-12-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.