Provider Demographics
NPI:1952539769
Name:KIDDY, ROBERT ALFRED III (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALFRED
Last Name:KIDDY
Suffix:III
Gender:M
Credentials:DPM
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Mailing Address - Street 1:PO BOX 4920
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99302-4920
Mailing Address - Country:US
Mailing Address - Phone:509-581-2830
Mailing Address - Fax:509-581-2832
Practice Address - Street 1:8479 W CLEARWATER AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-8628
Practice Address - Country:US
Practice Address - Phone:509-581-2830
Practice Address - Fax:509-581-2832
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2023-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX21893889213ES0103X
WAPO60305797213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery