Provider Demographics
NPI:1386650406
Name:KINCAID, ROBERT GERALD III (DO)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:GERALD
Last Name:KINCAID
Suffix:III
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:3754 HIGHWAY 90
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-1096
Mailing Address - Country:US
Mailing Address - Phone:850-416-5200
Mailing Address - Fax:
Practice Address - Street 1:3754 HIGHWAY 90
Practice Address - Street 2:SUITE 200
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-1096
Practice Address - Country:US
Practice Address - Phone:850-416-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006018040207Q00000X
FLOS 10119207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine