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Individual
TYLER TIDWELL
Active
Individual
TYLER TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07001297A
IN
213E00000X
Podiatrist
244018
KY
213ES0103X
Foot & Ankle Surgery Podiatrist
41000347A
IN
Other
Enumeration date
03/27/2015
Last updated
11/19/2019
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