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.
Provider's Profile
Full Name | Mr Larry E Tidyman |
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Gender | Male |
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Speciality | Physician Assistant - Medical |
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Location | 1313 N Cheyenne St, Benkelman, Nebraska |
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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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