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NPI Code Detail

MEDICARE: DALTON TIDWELL MD

MEDICARE: DALTON TIDWELL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianV6106TX

General Provider Information

NPI Number : 1174261192
Entity Type Code : Individual
Provider Name (Legal Business Name) : DALTON TIDWELL MD
Provider Business Mailing Address
First Line : 1906 W US HIGHWAY 82
Second Line :
City : SHERMAN
State : TX
Zip : 75092-6893
Country : US
Telephone Number : 903-892-8398
Fax Number : 903-892-6665
Provider Business Practice Location Address
First Line : 1906 W US HIGHWAY 82
Second Line :
City : SHERMAN
State : TX
Zip : 75092-6893
Country : US
Telephone Number : 903-892-8398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2022
Last Update Date : 05/27/2026

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Directions to “ DALTON TIDWELL MD” Practice Location

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