Tidwell, Travis
Tidwell, Travis is an individual health care provider with primary practice located at 2710 Saint Francis Dr Ste 510 , Waterloo IA 50702-5620. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Tidwell, Travis can be contacted via phone (319) 272-5000.Contact Information
Primary practice address
2710 Saint Francis Dr Ste 510
Waterloo IA 50702-5620
Phone: (319) 272-5000
Fax: (319) 272-5236
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 5593046-0501 | Utah |
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 074484 | Iowa |
Profile Details
| NPI number | 1043627292 |
|---|---|
| LBN Legal business name | Tidwell, Travis |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2014 |
| Last updated | May 16th, 2022 - about 2 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.
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