person
Justin L Kidd, PA
Surgical Physician Assistant in Colorado Springs, Colorado
NPI 1740279884

Justin L Kidd is a Surgical Physician Assistant based in Las Vegas, CO and is specialized in Surgical. Justin L Kidd practices in Colorado Springs, CO and has the professional credentials of PA. The NPI Number for Justin L Kidd is 1740279884 and holds a License No. PA-003632 (Colorado).

The current practice location address for Justin L Kidd is 1725 E Boulder St, Colorado Springs, CO and can be reached out via phone at 719-365-9916 and via fax at 719-365-9969.

Location: 1725 E Boulder St, Colorado Springs, CO, 89133-5380
person
Provider Profile Details
NPI Number
1740279884
Provider Name
Justin L Kidd
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
1725 E Boulder St, Colorado Springs, CO, 89133-5380
Phone Number
719-365-9916
Fax Number
719-365-9969
Provider Enumeration Date
10/20/2005
Last Update Date
09/14/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
38527057 05 CO
institution
Provider Business Practice Location Address Details
Address
1725 E Boulder St
City
State
Zip
80909-5768
Phone Number
719-365-9916
Fax Number
719-365-9969
person
Provider Business Mailing Address Details
Address
1725 E Boulder St
City
State
Zip
80909-5768
Phone Number
719-365-9916
Fax Number
719-365-9969
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA-003632 (Colorado)
Definition
Definition to come...
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