Provider Demographics
NPI:1407935281
Name:KIDD, JAMES MARION III (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MARION
Last Name:KIDD
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8017 PICARDY AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3538
Mailing Address - Country:US
Mailing Address - Phone:225-769-4432
Mailing Address - Fax:225-768-7642
Practice Address - Street 1:8017 PICARDY AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3538
Practice Address - Country:US
Practice Address - Phone:225-769-4432
Practice Address - Fax:225-768-7642
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA013808207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5K102Medicare ID - Type Unspecified
LAB60726Medicare UPIN