Albert Tydings MD, Apmc
Organization Active NPI Obstetrics & Gynecology Physician · Covington, LA
NPI 1376840116 · NPPES record last updated Sep 12, 2011
Key facts
- NPI
- 1376840116
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 05024R (LA)
- Legal business name
- ALBERT TYDINGS MD, APMC
- Practice address
- 121 Lakeview Cir Ste C
Covington, LA 70433-7513 - Phone
- (985) 892-1111
- Fax
- (985) 892-1116
- NPI assigned
- Feb 14, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Albert Irving Tydings, M.D.
- Title
- President
- Phone
- (985) 892-1111
Practitioners 1
-
Albert I Tydings, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110721000086 | LA | Part B Supplier - Clinic/Group Practice | 8729256664 |
Receives reassigned benefits from 1 practitioner Practice locations: Covington, LA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | 05024R | LA | Yes |
Addresses
Primary practice location
121 Lakeview Cir Ste C
Covington, LA 70433-7513
Mailing address
121 Lakeview Cir Ste C
Covington, LA 70433-7513
Phone (985) 892-1111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1300446 | Medicaid | LA | |
| 2128906 | Medicaid | LA |
Other providers in Covington, LA
- Allie Ainsworth
- Shanti Akasapu
- Al IV Enterprises Inc
- Crystal Alack
- Alan James Klein, PH.D., a Professional Psychology Corporation
- Andrea Alcon
- Jennifer Aldana
- Alexander Milne Developmental Services
- Carlissa Alexander
- Charles Franklin Alexander Jr.
All providers in Covington, LA · Obstetrics & Gynecology Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.