Individual provider · Type 1 NPI

Eric Lee Tidwell

Student in an Organized Health Care Education/Training Program · Albuquerque, NM

NPI number 1508506205 Active

Practice location

5530 1 University Of New Mexico
Albuquerque, NM 87131-0001

Call (505) 272-2269 Map

Fax (505) 272-5821

Mailing address

1 University Of New Mexico
Albuquerque, NM 87131-0001

Other practice locations

  • 3214 E Race Ave, Searcy, AR 72143-4810 · (501) 350-1548

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed
General Practice Physician 208D00000X010737 (AZ)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1508506205

Eric Lee Tidwell's National Provider Identifier is 1508506205, issued on Mar 30, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Albuquerque, NM. The record was last updated on May 3, 2024.