Provider Demographics
NPI:1508952813
Name:KINCAID, REID (PA-C)
Entity Type:Individual
Prefix:MR
First Name:REID
Middle Name:
Last Name:KINCAID
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:MR
Other - First Name:ASHLEY
Other - Middle Name:REID
Other - Last Name:KINCAID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:581 S STRONG RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-5108
Mailing Address - Country:US
Mailing Address - Phone:207-778-9901
Mailing Address - Fax:
Practice Address - Street 1:250 ARSENAL ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5742
Practice Address - Country:US
Practice Address - Phone:207-779-7484
Practice Address - Fax:207-287-6123
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA769363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEPA769OtherLICENSE
MEPA769OtherLICENSE