Provider Demographics
NPI:1588008429
Name:KINCAID, NATHAN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:WILLIAM
Last Name:KINCAID
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4300 BARTLETT ST
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-7000
Mailing Address - Country:US
Mailing Address - Phone:907-235-3225
Mailing Address - Fax:907-235-3203
Practice Address - Street 1:203 W PIONEER AVE
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:AK
Practice Address - Zip Code:99603-7527
Practice Address - Country:US
Practice Address - Phone:907-235-3225
Practice Address - Fax:907-235-3203
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA080536208600000X
AK185476208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery