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Individual

JOHN ROBERT KIDD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2320 PASEO DEL PRADO, # B-207, LAS VEGAS, NV 89102-4358
(702) 873-4567
(702) 873-0414
Mailing address
324 GANNETT DR, STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7800
(207) 482-7898

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
8161
NV
207L00000X
Anesthesiology Physician
Primary
MD24096
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002019867
NV
Enumeration date
06/30/2005
Last updated
04/20/2021
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