Individual
DR. WILLIAM JAMES TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
51181
KY
207N00000X
Dermatology Physician
A147575
CA
207ND0101X
MOHS-Micrographic Surgery Physician
51181
KY
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
56778
TN
207ND0101X
MOHS-Micrographic Surgery Physician
A14575
CA
Other
Enumeration date
05/24/2013
Last updated
12/29/2023
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