Provider Demographics
NPI:1134221526
Name:BIDDLE, MARTHA SUE (ARNP)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:SUE
Last Name:BIDDLE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 CLINIC DRIVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361
Mailing Address - Country:US
Mailing Address - Phone:859-987-0074
Mailing Address - Fax:859-987-0098
Practice Address - Street 1:22 CLINIC DRIVE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361
Practice Address - Country:US
Practice Address - Phone:859-987-0074
Practice Address - Fax:859-987-0098
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2577P207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78005527Medicaid
P10280Medicare UPIN
0053307Medicare ID - Type Unspecified