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DR. KENNETH KELLEY TIDWELL JR. M.D.
NPI 1942205802
Radiology - Diagnostic Radiology in Jonesboro, AR

Active since June 16, 2005
225 E JACKSON AVE, JONESBORO, AR 72401(870) 932-0639(870) 932-0526 Get Directions Write a Review

NPPES record last updated: February 15, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Kenneth Kelley Tidwell Jr. M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KENNETH KELLEY TIDWELL JR. M.D. (NPI 1942205802) is an individual diagnostic radiology provider in Jonesboro, Arkansas, licensed in Arkansas (N7857) and active in the NPI registry since June 2005.

NPPES Registry Identity

NPI1942205802
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameDR. KENNETH KELLEY TIDWELL JR.Credential: M.D.
Location Address225 E JACKSON AVEJonesboro, AR 72401-3119
Mailing Address800 S Church St Ste 101Jonesboro, AR 72401-4154 · (870) 932-0639 · Fax (870) 932-0526
Phone(870) 932-0639
Fax(870) 932-0526
Sole ProprietorNo
Enumeration DateJune 16, 2005
Last NPPES UpdateFebruary 15, 2011
✔ NPI 1942205802 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in AR · N7857
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
225 E JACKSON AVE, Jonesboro, AR 72401
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Other Identifiers 4

Medicare ID-Type Unspecified53545
Medicaid117697001AR
Medicare UPINE29014
Medicaid208891408MO

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSE ASH APRN
Nurse Practitioner (Family)
225 E JACKSON AVE
JONESBORO, AR 72401
Craighead County (870) 207-4100
MS. SONIA R JOSEPH DO
Obstetrics & Gynecology
225 E JACKSON AVE, MAILSLOT #83
JONESBORO, AR 72401
Craighead County (870) 207-1630
WILLIAM C MCBRYDE M.D.
Emergency Medicine (Emergency Medical Services)
225 E JACKSON AVE
JONESBORO, AR 72401
Craighead County (870) 972-4145
JONESBORO ANESTHESIA INC
Anesthesiology
225 E JACKSON AVE
JONESBORO, AR 72401
Craighead County (870) 932-4211
EDMUND CARMACK CRNA
Nurse Anesthetist, Certified Registered
225 E JACKSON AVE
JONESBORO, AR 72401
Craighead County (870) 932-4211
DR. RICHARD E PERSON M.D.
Radiology (Diagnostic Radiology)
225 E JACKSON AVE
JONESBORO, AR 72401
Craighead County (870) 910-6654
HOLLEY ALEECE FOWLER
Nurse Practitioner (Family)
225 E JACKSON AVE
JONESBORO, AR 72401
Craighead County (870) 207-4100
DR. JOSE ANDRES FABRE QUINONES MD
Internal Medicine
225 E JACKSON AVE
JONESBORO, AR 72401
Craighead County (870) 277-8221

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Tidwell's NPI number?

The NPI number for Kenneth Tidwell is 1942205802. It was assigned to this individual provider in the NPPES registry on June 16, 2005.

Where is Kenneth Tidwell located?

Kenneth Tidwell practices at 225 E Jackson Ave, Jonesboro, AR 72401. The listed phone number is (870) 932-0639.

What is Kenneth Tidwell's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

When was this NPI record last updated?

The NPPES record for Kenneth Tidwell was last updated on February 15, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.