Provider Demographics
NPI:1356321913
Name:KINCAID, ROBERT L (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:L
Last Name:KINCAID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6715 W HIGHWAY 98
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-5923
Mailing Address - Country:US
Mailing Address - Phone:850-453-6737
Mailing Address - Fax:
Practice Address - Street 1:6715 W HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-5923
Practice Address - Country:US
Practice Address - Phone:850-453-6737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME49051207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL080180481OtherRAILROAD MEDICARE
FL373697100Medicaid
AL59167047OtherBLUE CROSS BLUE SHIELD AL
FL02924OtherBLUE CROSS BLUE SHIELD FL
FLA050OtherHEALTH FIRST NETWORK
FL373697100Medicaid
FL373697100Medicaid