Individual provider · Type 1 NPI

Larry E. Tidyman, PA-C

Medical Physician Assistant · Benkelman, NE

NPI number 1972690345 Active

Practice location

1313 N Cheyenne St
Benkelman, NE 69021-3074

Call (308) 423-2151 Map

Fax (308) 423-2217

Mailing address

PO Box 710
Benkelman, NE 69021-0710

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X343 (NE)

Medical Physician Assistant: Definition to come...

12 other providers at this address

About NPI 1972690345

Larry E. Tidyman, PA-C's National Provider Identifier is 1972690345, issued on Oct 6, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Benkelman, NE. The record was last updated on Sep 1, 2010.