| Doctor Name: | JASON S. KIDD |
| NPI Number: | 1093939183 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 01023 |
| Business Practice Address: | 924 Liberty Street West Milford, WV - 26451 |
| Business Phone Number: | 3047454568 |
| Business Fax Number: | 3043263700 |
| Mailing Address: | Po Box 217, ROCK CAVE |
| State: | WV |
| Postal Code: | 262340217 |
| Phone Number: | 3049246262 |
| Fax Number: | 3049245460 |
| NPI Enumeration Date: | 04/12/2007 |
| NPI Last Update Date: | 07/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 01023 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |