Organization
DR. KAREN A. TIDMORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN TIDMORE (FAMILY PRACTICE)
(931) 967-7716
Entity
Organization
Contact information
Practice address
1811 SHARP SPRINGS RD, WINCHESTER, TN 37398-4659
(931) 967-7716
Mailing address
1811 SHARP SPRINGS RD, WINCHESTER, TN 37398-4659
(931) 967-7716
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO 0000000400
TN
363LF0000X
Family Nurse Practitioner
APN0000015232
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0058092
BCBS
TN
01
—
4441604
CIGNA
TN
Enumeration date
01/14/2015
Last updated
01/14/2015
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