Provider Demographics
NPI:1609766799
Name:SIDDONS, KEVIN (EDD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:SIDDONS
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-1828
Mailing Address - Country:US
Mailing Address - Phone:610-504-2237
Mailing Address - Fax:
Practice Address - Street 1:1550 WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-1828
Practice Address - Country:US
Practice Address - Phone:610-504-2237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer