Tidwell, Patrick R
Tidwell, Patrick R is an sole proprietor health care provider with primary practice located at 1425 I-65 Parkway , Montgomery AL 36106-2860. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Tidwell, Patrick R can be contacted via phone (404) 989-2867.Contact Information
Primary practice address
1425 I-65 Parkway
Montgomery AL 36106-2860
Phone: (404) 989-2867
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 251S00000X | Alabama |
Profile Details
| NPI number | 1316450976 |
|---|---|
| LBN Legal business name | Tidwell, Patrick R |
| Credentials | PH.D, LMFT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 6th, 2017 |
| Last updated | Nov 6th, 2017 - about 7 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316450976 | NPPES |
| Alabama | MEDICAID | 251S00000X |
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