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Mr. Larry E. Tidyman, PA-C
Medical Physician Assistant in Benkelman, Nebraska
NPI 1972690345

Larry E. Tidyman is a Medical Physician Assistant based in Benkelman, NE and is specialized in Medical. Larry E. Tidyman practices in Benkelman, NE and has the professional credentials of PA-C. The NPI Number for Larry E. Tidyman is 1972690345 and holds a License No. 343 (Nebraska).

The current practice location address for Larry E. Tidyman is 1313 N Cheyenne St, Benkelman, NE and can be reached out via phone at 308-423-2151 and via fax at 308-423-2217.

Location: 1313 N Cheyenne St, Benkelman, NE, 69021-0710
person
Provider Profile Details
NPI Number
1972690345
Provider Name
Larry E. Tidyman
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
1313 N Cheyenne St, Benkelman, NE, 69021-0710
Phone Number
308-423-2151
Fax Number
308-423-2217
Provider Enumeration Date
10/06/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
37814 01 NE BCBS OF NE
2287458901 05 KS
institution
Provider Business Practice Location Address Details
Address
1313 N Cheyenne St
City
State
Zip
69021-3074
Phone Number
308-423-2151
Fax Number
308-423-2217
person
Provider Business Mailing Address Details
Address
1313 N Cheyenne St
City
State
Zip
69021-3074
Phone Number
308-423-2151
Fax Number
308-423-2217
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
343 (Nebraska)
Definition
Definition to come...
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