Individual
THOMAS ALI KIDD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
190 CAMPUS BLVD, SUITE 200, WINCHESTER, VA 22601
(540) 662-0306
(540) 662-5845
Mailing address
PO BOX 1671, CUMBERLAND, MD 21501-1671
(240) 964-8342
(240) 964-8337
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1053
WV
363A00000X
Physician Assistant
C0000621
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970016137
RAILROAD MEDICARE
—
Enumeration date
08/09/2006
Last updated
04/07/2022
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