Individual
DR. WILLIAM JAMES TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 SPRINGHOUSE CT, HENDERSONVILLE, TN 37075-1609
(615) 824-7491
(615) 449-5740
Mailing address
107 GLIDEPATH WAY, LEBANON, TN 37090-4133
(615) 449-5771
(615) 449-5740
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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