AUSTIN TIDWELL

JOHNSON CITY, NY
NPI1366862690
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy208M00000X Hospitalist
(Licence: CA  14843)
Additional Taxonomies207R00000X Internal Medicine
(Licence: CA  14843)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2014-04-25
Last Update Date2022-05-25
Business Address
AUSTIN TIDWELL
33-57 HARRISON ST
JOHNSON CITY, NY 13790-2107
Phone number: 607-763-6674
Mailing Address
AUSTIN TIDWELL
33-57 HARRISON ST
JOHNSON CITY, NY 13790-2107
Phone number: