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NPI Code Detail

MEDICARE: DR. CHRISTOPHER W KIDWELL JR. MD

MEDICARE: DR. CHRISTOPHER W KIDWELL JR. MD
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
1207Q00000XFamily Medicine Physician01067467AIN

Other Identifiers

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

General Provider Information

NPI Number : 1982869590
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTOPHER W KIDWELL JR. MD
Provider Business Mailing Address
First Line : 1503 N MITTHOEFER RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46229-2425
Country : US
Telephone Number : 317-934-0750
Fax Number :
Provider Business Practice Location Address
First Line : 1315 N ARLINGTON AVE STE 220
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-3204
Country : US
Telephone Number : 317-762-0190
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2008
Last Update Date : 10/13/2025

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