DR. DALE ROGER TIDABACK (MD, MPH) – Aerospace Medicine Physician, NPI 1710963772

DR. DALE ROGER TIDABACK (MD, MPH) is a healthcare provider. based in Wright patterson afb, Ohio. specializing in Aerospace Medicine Physician. They hold the professional credentials MD, MPH. They hold a License No. 1559 (SD). The NPI Number for DR. DALE ROGER TIDABACK (MD, MPH) is 1710963772

Main info

Male
Sole Proprietor
Name
DR. DALE ROGER TIDABACK (MD, MPH)
NPI
1710963772
Phone
(703) 994-8148
Address
4881 SUGAR MAPLE DR
Enumeration Date
21 December 2005
Last Update Date
2 December 2014
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. DALE ROGER TIDABACK (MD, MPH)

  • Wright-Patterson Medical Center, 4881, Sugar Maple Drive, Buckeye Trailer Court, Greene County, Ohio, 45433, United States

    WRIGHT PATTERSON AFB, OH 454335529

    Phone: (703) 994-8148

    Type: Location

  • 9200 ARMETALE CT

    FAIRFAX STATION, VA 220393111

    Phone: (703) 690-1448

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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Medicare Utilization (FFS)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 45433)

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Frequently asked questions

What number should I use to identify DR. DALE ROGER TIDABACK (MD, MPH) for billing?
Administrative and clinical systems typically use NPI 1710963772 for DR. DALE ROGER TIDABACK (MD, MPH).
Is DR. DALE ROGER TIDABACK (MD, MPH)'s NPI status active today?
Active status means DR. DALE ROGER TIDABACK (MD, MPH)'s NPI record is not deactivated in the public file.
Which specialty label fits DR. DALE ROGER TIDABACK (MD, MPH)?
NPPES ties DR. DALE ROGER TIDABACK (MD, MPH) to Aerospace Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. DALE ROGER TIDABACK (MD, MPH)?
DR. DALE ROGER TIDABACK (MD, MPH) shows a connection to Wright Patterson Afb, Ohio in registry-derived data.
Who maintains DR. DALE ROGER TIDABACK (MD, MPH)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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