Individual provider · Type 1 NPI

Mackenzie R. Tiderington, P.A-C

Physician Assistant · Dayton, OH

NPI number 1114577103 Active

Practice location

4160 Little York Rd Ste 10
Dayton, OH 45414-5803

Call (937) 415-9100 Map

Fax (937) 415-9191

Mailing address

6551 Centerville Business Pkwy Ste 120
Centerville, OH 45459-2696

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X50.006159RX (OH)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1114577103

Mackenzie R. Tiderington, P.A-C's National Provider Identifier is 1114577103, issued on Sep 12, 2019. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Dayton, OH. The record was last updated on Dec 4, 2022.