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JAMES ELLIOTT TIDWELL MD NPI 1942427380


NPI Information

NPI: 1942427380
Provider Name: JAMES ELLIOTT TIDWELL, MD
Classification: Surgery - 2086S0122X
Entity Type: Individual

Specialization: Plastic and Reconstructive Surgery

PECOS Registration: Yes

Address:
2211 MAYFAIR DR STE 305
OWENSBORO, KY
ZIP 42301
Phone: (270) 688-3700
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James Elliott Tidwell, MD is a plastic and reconstructive surgery surgery in Owensboro, KY with 19 years of experience. The provider is a surgeon who specializes in plastic and reconstructive surgery. James Elliott Tidwell, MD NPI is 1942427380. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: BAYLOR COLLEGE OF MEDICINE
Graduation Year:2005

The provider's business location address is:

2211 MAYFAIR DR STE 305
OWENSBORO, KY
ZIP 42301-572
Phone: (270) 688-3700
Fax: (270) 688-3709

The NPI 1942427380 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 4/19/2007 and was last updated on 7/1/2021.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208200000XPlastic Surgery47992KENTUCKYNo
22086S0122XSurgeryPlastic and Reconstructive Surgery47992KENTUCKYYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.