Individual
MR. MARK A KIDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3630 11TH AVE NW, ROCHESTER, MN 55901-4276
(507) 288-2457
(507) 288-1299
Mailing address
3630 11TH AVE NW, ROCHESTER, MN 55901-4276
(507) 288-2457
(507) 288-1299
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2742
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03S15KI
BCBS OF MN
MN
01
—
1024471
PREFERRED ONE
—
01
—
2201279
MEDIEA CHOICE SELECT
—
05
—
743070100
—
MN
01
—
HP44092
HEALTHPARTNERS
—
Enumeration date
12/01/2005
Last updated
05/28/2009
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