Individual
JOHN EDWARD TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
702 E BELL RD STE 117, PHOENIX, AZ 85022-6648
(480) 874-2040
(480) 874-2041
Mailing address
3126 N CIVIC CENTER PLZ, SCOTTSDALE, AZ 85251-6912
(480) 874-2040
(480) 874-2041
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
58407
AZ
207XX0801X
Orthopaedic Trauma Physician
Primary
58407
AZ
Other
Enumeration date
06/18/2008
Last updated
04/24/2024
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