Individual
CODY LEE KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
710 CHESTERFIELD HWY, CHERAW, SC 29520-7001
(843) 537-2171
Mailing address
555 E CHEVES ST, FLORENCE, SC 29506-2617
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
87607
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2022
Last updated
09/20/2023
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