Individual
TYLER TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
4233 GATEWAY BLVD, NEWBURGH, IN 47630-8900
(812) 858-5786
(812) 490-4512
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 450-6815
(812) 450-6822
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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