Provider Demographics
NPI:1538175039
Name:KIDD, THOMAS P JR (DPM)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:P
Last Name:KIDD
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 SIERRA CT
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-8771
Mailing Address - Country:US
Mailing Address - Phone:419-581-3563
Mailing Address - Fax:419-436-1760
Practice Address - Street 1:270 SIERRA CT
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-8771
Practice Address - Country:US
Practice Address - Phone:419-581-3563
Practice Address - Fax:419-436-1760
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36001273213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4674884Medicaid
OH0011571Medicare ID - Type Unspecified
OH4674884Medicaid