Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 33892 | AZ |
NPI | 1184717845 |
---|---|
Provider Name | Dr. Alexandra E Kidd |
First Address | Scottsdale, AZ 85258-4509 |
Second Address | Scottsdale, AZ 85258-4509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 13/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
884074 | (05) | AZ |
AZ0765120 | BCBS (01) | AZ |
AZ12006 | (02) | |
AZ12006 | (02) | AZ |
I21417 | (02) | AZ |