Tidmore, Paul Timothy

Tidmore, Paul Timothy is an individual health care provider with primary practice located at 2210 Sutherland Ave Ste 110 , Knoxville TN 37919-2337. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as his primary health care specialty. Tidmore, Paul Timothy can be contacted via phone (865) 525-4333.

Contact Information

Primary practice address
2210 Sutherland Ave Ste 110 Knoxville TN 37919-2337
Phone: (865) 525-4333
Fax: (865) 374-2203
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 14982 Tennessee

Profile Details

NPI number 1457671380
LBN Legal business name Tidmore, Paul Timothy
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2010
Last updated Apr 24th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457671380 NPPES
Tennessee MEDICAID 1523332

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