Individual
DR. MYKEL LINN TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1520 CUBA RD, MAYFIELD, KY 42066-6809
(270) 705-1141
Mailing address
66 LAKE TERRY DR, MAYFIELD, KY 42066-6982
(270) 705-1141
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
015489
KY
Other
Enumeration date
01/04/2012
Last updated
09/27/2024
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