Individual
BENJAMIN GLENN KIDDER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10101 PARK ROWE AVE STE 200, BATON ROUGE, LA 70810-1685
(225) 769-2200
(225) 768-2185
Mailing address
PO BOX 98509, BATON ROUGE, LA 70884-9509
(225) 769-2200
(225) 768-2185
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
203585
LA
Other
Enumeration date
02/04/2010
Last updated
03/23/2010
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