Provider Demographics
NPI:1982753919
Name:KIDD, JAMES EARL (MED)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EARL
Last Name:KIDD
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 COREY AVE
Mailing Address - Street 2:
Mailing Address - City:BRADDOCK
Mailing Address - State:PA
Mailing Address - Zip Code:15104-1503
Mailing Address - Country:US
Mailing Address - Phone:412-271-8159
Mailing Address - Fax:
Practice Address - Street 1:723 BRADDOCK AVE
Practice Address - Street 2:
Practice Address - City:BRADDOCK
Practice Address - State:PA
Practice Address - Zip Code:15104-1849
Practice Address - Country:US
Practice Address - Phone:412-351-0222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor