Kidd, Gena R

Kidd, Gena R is an individual health care provider with primary practice located at 1400 Teal Rd Suite 8, Lafayette IN 47905-2463. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Kidd, Gena R can be contacted via phone (765) 477-2020.

Contact Information

Primary practice address
1400 Teal Rd Suite 8 Lafayette IN 47905-2463
Fax: (765) 477-8200
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 01054602A Indiana

Profile Details

NPI number 1922072339
LBN Legal business name Kidd, Gena R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2006
Last updated May 2nd, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922072339 NPPES
Indiana MEDICAID 200349180

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