Provider Demographics
NPI:1881759298
Name:TILDEN, MORRIS EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:MORRIS
Middle Name:EDWARD
Last Name:TILDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2155 WESTLAKE DR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-8126
Mailing Address - Country:US
Mailing Address - Phone:303-682-5064
Mailing Address - Fax:303-682-5211
Practice Address - Street 1:2155 WESTLAKE DR
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-8126
Practice Address - Country:US
Practice Address - Phone:303-682-5064
Practice Address - Fax:303-682-5211
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34427207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COE60626Medicare UPIN