DR. KENNETH KELLEY JR. TIDWELL (M.D.) – Diagnostic Radiology Physician, NPI 1942205802

DR. KENNETH KELLEY JR. TIDWELL (M.D.) is a healthcare provider. based in Jonesboro, Arkansas. specializing in Diagnostic Radiology Physician. They hold the professional credentials M.D.. They hold a License No. N7857 (AR). The NPI Number for DR. KENNETH KELLEY JR. TIDWELL (M.D.) is 1942205802

Main info

Male
Name
DR. KENNETH KELLEY JR. TIDWELL (M.D.)
NPI
1942205802
Phone
(870) 932-0639
Address
800 S CHURCH ST STE 101
Enumeration Date
16 June 2005
Last Update Date
15 February 2011
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. KENNETH KELLEY JR. TIDWELL (M.D.)

  • South Church Street, Jonesboro, Craighead County, Arkansas, 72401, United States

    JONESBORO, AR 724014154

    Phone: (870) 932-0639

    Fax: (870) 932-0526

    Type: Mailing

  • East Jackson Avenue, Jonesboro, Craighead County, Arkansas, 72401, United States

    JONESBORO, AR 724013119

    Phone: (870) 932-0639

    Fax: (870) 932-0526

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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Medicare Utilization (FFS)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72401)

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Reviews

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Frequently asked questions

Can I verify DR. KENNETH KELLEY JR. TIDWELL (M.D.) with an NPI only?
You can start verification with NPI 1942205802 for DR. KENNETH KELLEY JR. TIDWELL (M.D.), then check state licensing separately.
Is DR. KENNETH KELLEY JR. TIDWELL (M.D.) listed as active for patients and plans?
The listing shows DR. KENNETH KELLEY JR. TIDWELL (M.D.) as active in the NPI system.
What is DR. KENNETH KELLEY JR. TIDWELL (M.D.) best known for clinically?
Directory data describes DR. KENNETH KELLEY JR. TIDWELL (M.D.) with Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
What address line appears for DR. KENNETH KELLEY JR. TIDWELL (M.D.)?
DR. KENNETH KELLEY JR. TIDWELL (M.D.)'s geographic hint is Jonesboro, Arkansas in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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