Kidwell, Walter M
Kidwell, Walter M is an individual health care provider with primary practice located at 7435 W Azure Dr Ste 190 , Las Vegas NV 89130-4427. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Pain Medicine, which is considered as his primary health care specialty. Kidwell, Walter M can be contacted via phone (702) 788-5252.Contact Information
Primary practice address
7435 W Azure Dr Ste 190
Las Vegas NV 89130-4427
Phone: (702) 788-5252
Fax: (702) 878-9096
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 9263 | Nevada |
Profile Details
| NPI number | 1215977038 |
|---|---|
| LBN Legal business name | Kidwell, Walter M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2006 |
| Last updated | Jun 12th, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215977038 | NPPES |
| Nevada | Other | 33452 | MEDICARE ORIGINAL |
| Nevada | Other | 100791 | MEDICARE ORIGINAL |
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