Provider Demographics
NPI:1407174071
Name:KINCAID, JOSEPH ANDERSON JR (DVM, ND)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ANDERSON
Last Name:KINCAID
Suffix:JR
Gender:M
Credentials:DVM, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:ANTHONY
Mailing Address - State:TX
Mailing Address - Zip Code:79821-7186
Mailing Address - Country:US
Mailing Address - Phone:915-886-4558
Mailing Address - Fax:915-886-2556
Practice Address - Street 1:901 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:ANTHONY
Practice Address - State:TX
Practice Address - Zip Code:79821-7186
Practice Address - Country:US
Practice Address - Phone:915-886-4558
Practice Address - Fax:915-886-2556
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC04470133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist