Provider Demographics
NPI:1184717845
Name:KIDD, ALEXANDRA E (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:E
Last Name:KIDD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10210 N 92ND ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4509
Mailing Address - Country:US
Mailing Address - Phone:480-291-6620
Mailing Address - Fax:480-219-2213
Practice Address - Street 1:10210 N 92ND ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4509
Practice Address - Country:US
Practice Address - Phone:480-291-6620
Practice Address - Fax:480-219-2213
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2015-11-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ33892207VG0400X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ884074Medicaid
AZAZ0765120OtherBCBS
AZAZ0765120OtherBCBS
AZ12006Medicare UPIN
AZAZ12006Medicare UPIN