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General NPI Number Information
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NPI Number | 1265552210
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Entity Type | Individual
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Provider Name | GERALD STEELE KIDD III PA-C
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Gender | Male
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 13952 DENVER WEST PKWY STE 100
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City | LAKEWOOD
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State | CO
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Zip | 80401-3141
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Country | US
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Telephone | 303-604-5000
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Fax | 720-890-0364
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Provider Business Mailing Address
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Address Line | 382 S ARTHUR AVE
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City | LOUISVILLE
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State | CO
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Zip | 80027-3094
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Country | US
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Telephone | 303-604-5000
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Fax | 720-890-0364
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA.0004075
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License Number State | CO
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