Provider Demographics
NPI:1366575615
Name:KIDD AND ASSOCICATES LLC
Entity type:Organization
Organization Name:KIDD AND ASSOCICATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/BILLER
Authorized Official - Prefix:
Authorized Official - First Name:KRISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-828-3651
Mailing Address - Street 1:1500 NORTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:LA
Mailing Address - Zip Code:70538
Mailing Address - Country:US
Mailing Address - Phone:337-828-3651
Mailing Address - Fax:337-828-0586
Practice Address - Street 1:1500 NORTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:LA
Practice Address - Zip Code:70538-3442
Practice Address - Country:US
Practice Address - Phone:337-828-3651
Practice Address - Fax:337-828-0586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
152W00000X
LA753-087T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1170534Medicaid
LAT19440OtherUPIN
LA439064365BOtherCOMEAUX BC FKLN
LA19040283Medicaid
LA434689892BOtherIII BLUE CROSS FKLN
LA4085840002Medicare NSC
LA19040283Medicaid
LAT19440Medicare UPIN
LA1170534Medicaid
LA4085840001Medicare NSC