Individual provider · Type 1 NPI

Dale Roger Tidaback, MD, MPH

Aerospace Medicine Physician · Wright Patterson Afb, OH

NPI number 1710963772 Active

Practice location

4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5529

Call (703) 994-8148 Map

Mailing address

9200 Armetale Ct
Fairfax Station, VA 22039-3111

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician 207Q00000X1559 (SD)
Aerospace Medicine Physician Primary 2083A0100X1559 (SD)

Aerospace Medicine Physician: Aerospace medicine focuses on the clinical care, research, and operational support of the health, safety, and performance of crewmembers and passengers of air and space vehicles, together with the support personnel who assist operation of such vehicles. This population often works and lives in remote, isolated, extreme, or enclosed environments under conditions of physical and psychological stress. Practitioners str…

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About NPI 1710963772

Dale Roger Tidaback, MD, MPH's National Provider Identifier is 1710963772, issued on Dec 21, 2005. The primary taxonomy on file is Aerospace Medicine Physician (2083A0100X), and the practice location is in Wright Patterson Afb, OH. The record was last updated on Dec 2, 2014.