Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JAMES ELLIOTT TIDWELL III, MD
ActiveJAMES ELLIOTT TIDWELL III, MD is a Plastic and Reconstructive Surgery healthcare provider located in OWENSBORO, Kentucky. NPI 1942427380 is currently active in the NPPES registry. Verify at CMS.
Plastic and Reconstructive Surgery · OWENSBORO, KY
Registration Details
- NPI Number
- 1942427380
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 19, 2007 (19.333054283699 yrs)
- Last Updated
- Jul 1, 2021
- Licenses
-
47992 (KY)47992 (KY)
Practice Information
- Address
-
2211 MAYFAIR DR STE 305OWENSBORO, KY, 423014572Browse KY providers · Browse ZIP 42301
- Phone
- 2706883700
- Fax
- 2706883709
- Primary Specialty
-
Plastic and Reconstructive Surgery
2086S0122X
- Additional Specialty
- Plastic and Reconstructive Surgery
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.