person
Justin Alan Tidwell, DPM
Foot & Ankle Surgery Podiatrist in Portland, Oregon
NPI 1710908892

Justin Alan Tidwell is a Foot & Ankle Surgery Podiatrist based in Portland, OR and is specialized in Foot & Ankle Surgery. Justin Alan Tidwell practices in Portland, OR and has the professional credentials of DPM. The NPI Number for Justin Alan Tidwell is 1710908892 and holds a License No. PO00000806 (Oregon).

The current practice location address for Justin Alan Tidwell is 501 N Graham St, Portland, OR and can be reached out via phone at 503-413-2005 and via fax at 503-413-3699.

Location: 501 N Graham St, Portland, OR, 97211-5447
person
Provider Profile Details
NPI Number
1710908892
Provider Name
Justin Alan Tidwell
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
501 N Graham St, Portland, OR, 97211-5447
Phone Number
503-413-2005
Fax Number
503-413-3699
Provider Enumeration Date
07/22/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
501 N Graham St
City
State
Zip
97227-1654
Phone Number
503-413-2005
Fax Number
503-413-3699
person
Provider Business Mailing Address Details
Address
501 N Graham St
City
State
Zip
97227-1654
Phone Number
503-413-2005
Fax Number
503-413-3699
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
PO00000806 (Washington)
Definition
Definition to come...
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