MEDICARE: DR. KASH KENDALL BIDDLE DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	2152	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073566659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KASH KENDALL BIDDLE DO

Provider Business Mailing Address
First Line	:	3300 S ASPEN AVE
Second Line	:	STE C
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012-7501
Country	:	US
Telephone Number	:	918-455-2416
Fax Number	:	918-455-7546

Provider Business Practice Location Address
First Line	:	3300 S ASPEN AVE
Second Line	:	STE C
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012-7501
Country	:	US
Telephone Number	:	918-455-2416
Fax Number	:	918-455-7546

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	07/08/2007

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