PAUL TIMOTHY TIDMORE NP NPI 1457671380

NPI Information

Paul Timothy Tidmore, NP is an acute care nurse practitioner in Knoxville, TN with 15 years of experience. Paul Timothy Tidmore, NP NPI is 1457671380. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduation Year:2009

The provider's business location address is:

2210 SUTHERLAND AVE STE 110
KNOXVILLE, TN
ZIP 37919-337
Phone: (865) 525-4333
Fax: (865) 374-2203

The NPI 1457671380 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/2/2010 and was last updated on 4/24/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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