Provider Demographics
NPI:1114023587
Name:KINCAID, STEVEN J (MD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:J
Last Name:KINCAID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7203 W DESCHUTES AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7777
Mailing Address - Country:US
Mailing Address - Phone:509-737-1880
Mailing Address - Fax:509-737-1879
Practice Address - Street 1:216 W 10TH AVE
Practice Address - Street 2:STE 206
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-6300
Practice Address - Country:US
Practice Address - Phone:509-585-5320
Practice Address - Fax:509-585-5329
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00030523208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA020050103OtherRR MEDICARE
WA1114339Medicaid
WAAK1518034OtherDEA
D07401Medicare UPIN
WAAB24557Medicare ID - Type Unspecified