Kidd, Kenneth R

Kidd, Kenneth R is an individual health care provider with primary practice located at 1305 W Main St , Whitewater WI 53190-1503. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kidd, Kenneth R can be contacted via phone (262) 473-4548.

Contact Information

Primary practice address
1305 W Main St Whitewater WI 53190-1503
Fax: (262) 472-7691
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 23985-020 Wisconsin

Profile Details

NPI number 1427000967
LBN Legal business name Kidd, Kenneth R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Jan 22nd, 2016 - about 8 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 1427000967 NPPES
Wisconsin MEDICAID 142700967

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