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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. LARRY E. TIDYMAN, PA-C

Active

MR. LARRY E. TIDYMAN, PA-C is a Medical Physician Assistant healthcare provider located in BENKELMAN, Nebraska. NPI 1972690345 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · BENKELMAN, NE

Registration Details

NPI Number
1972690345
Provider Type
Individual
Gender
Male
NPI Issued
Oct 6, 2006 (19.902163818713 yrs)
Last Updated
Sep 1, 2010
License
343 (NE)

Practice Information

Address
1313 N CHEYENNE ST
BENKELMAN, NE, 690213074
Browse NE providers · Browse ZIP 69021
Phone
3084232151
Fax
3084232217
Primary Specialty
Medical Physician Assistant
363AM0700X
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.