Laura R Kidd in Carbondale - Physician Assistant
Laura R Kidd - NPI 1396842480
Laura R Kidd is a Physician Assistant in Carbondale, Illinois. Laura R Kidd practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Laura R Kidd is 1396842480. The last update date is 2022-07-21.
Laura R Kidd's current location address is 305 W Jackson St Ste 200, Carbondale, Illinois. You can contact this provider via phone number 6185366621 and fax number 6184531102. The mailing address for Laura R Kidd is 305 W Jackson St Ste 200, Carbondale, Illinois. To know further, please read the information below!
Provider Profile Detail
Provider Name | Laura R Kidd |
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Address | 305 W Jackson St Ste 200, Carbondale, Illinois |
Phone Number | 6185366621 |
Fax Number | 6184531102 |
Sole Proprietor | N |
Credentials | P.A. |
NPI Number Detail
NPI Number | 1396842480 |
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Provider Enumeration Date | 2006-09-20 |
Last Updated Date | 2022-07-21 |
Provider Mailing Address Detail
Address | 305 W Jackson St Ste 200 |
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City | Carbondale |
State | Illinois (IL) |
Post Code | 629011474 |
Phone Number | 6185366621 |
Fax Number | 6184531102 |
Provider's Primary Taxonomy Detail
Speciality | Physician Assistant |
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Taxonomy | 363A00000X |
Licence No | 85.00275 |
Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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085-002750 | IL | PHYSICIAN ASSISTANT LICENSE |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Laura R Kidd by the Centers for Medicare & Medicaid Services?
The Laura R Kidd has been assigned the NPI (National Provider Identifier) 1396842480 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Where is the Laura R Kidd located?
The Laura R Kidd is located at 305 W Jackson St Ste 200, Carbondale, IL 629011474.
What is Laura R Kidd's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Laura R Kidd is Physician Assistant, and the taxonomy code that categorizes this field of expertise is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1396842480 to Laura R Kidd?
The Centers for Medicare & Medicaid Services assigned the 1396842480 to Laura R Kidd on 2006-09-20.
As of what date was the information pertaining to Laura R Kidd, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Laura R Kidd, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2022-07-21.