Kidman, Mark A

Kidman, Mark A is an individual health care provider with primary practice located at 3630 11Th Ave Nw , Rochester MN 55901-4276. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Kidman, Mark A can be contacted via phone (507) 288-2457.

Contact Information

Primary practice address
3630 11Th Ave Nw Rochester MN 55901-4276
Phone: (507) 288-2457
Fax: (507) 288-1299
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2742 Minnesota

Profile Details

NPI number 1447234554
LBN Legal business name Kidman, Mark A
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2005
Last updated May 28th, 2009 - about 15 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 1447234554 NPPES
Other 2201279 MEDIEA CHOICE SELECT
Other 03S15KI MEDIEA CHOICE SELECT
Other 1024471 MEDIEA CHOICE SELECT
MEDICAID 743070100 MEDIEA CHOICE SELECT
Other HP44092 MEDIEA CHOICE SELECT

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