Mr Larry E Tidyman, PA-C in Benkelman, NE - Physician Assistant

Mr Larry E Tidyman, PA-C is a Physician Assistant - Medical based in Benkelman, Nebraska. Mr Larry E Tidyman is licensed to practice in Nebraska (license number 343) and his current practice location is 1313 N Cheyenne St, Benkelman, Nebraska. He can be reached at his office (for appointments etc.) via phone at (308) 423-2151.

NPI number for Mr Larry E Tidyman is 1972690345 and his current mailing address is Po Box 710, Benkelman, Nebraska. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1972690345.

Contact Information

	Mr Larry E Tidyman, PA-C
	1313 N Cheyenne St, Benkelman, NE 69021-3074
	(308) 423-2151
	(308) 423-2217

Provider's Profile

Full Name	Mr Larry E Tidyman
Gender	Male
Speciality	Physician Assistant - Medical
Location	1313 N Cheyenne St, Benkelman, Nebraska
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1972690345
Provider Enumeration Date: 10/06/2006
Last Update Date: 09/01/2010

Medical Identifiers

Medical identifiers for Mr Larry E Tidyman such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1972690345	NPI	-	NPPES
37814	Other	NE	BCBS OF NE
2287458901	Medicaid	KS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363AM0700X	Physician Assistant - Medical	343 (Nebraska)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Larry E Tidyman is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Larry E Tidyman, PA-C Po Box 710, Benkelman, NE 69021-0710 Ph: (308) 423-2151	Mr Larry E Tidyman, PA-C 1313 N Cheyenne St, Benkelman, NE 69021-3074 Ph: (308) 423-2151

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Mr Larry E Tidyman, PA-C - Physician Assistant in Benkelman, NE