Eric Lee Tidwell
Eric Lee Tidwell is a Student in an Organized Health Care Education/Training Program in Albuquerque, New Mexico. Practices as a sole proprietor and works from 2 locations. Licensed in Arizona and New Mexico.
- Licensed in
- AZ, NM
- In the registry since
- 2022
- Specialties on file
- 2
Practice location Address checks out
5530 1 University Of New MexicoAlbuquerque, NM 87131-0001
Phone: (505) 272-2269
Fax: (505) 272-5821
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 3214 E Race Ave, Searcy, AR 72143-4810 — (501) 350-1548
Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X (NM) |
|---|---|
| General Practice Physician | Taxonomy 208D00000X · Licence 010737 (AZ) |
Record details
| NPI number | 1508506205 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | March 30, 2022 |
| Last updated in NPPES | May 3, 2024 |
| Certification date | May 3, 2024 |
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