Individual provider · Type 1 NPI
Ricky L. Kidman, PA-C
Medical Physician Assistant · Aynor, SC
NPI number
1962466532
Active
Practice location
51 11th Avenue
Aynor, SC 29511-3249
Fax (843) 358-3707
Mailing address
300 Singleton Ridge Rd, Attention Pns Credentialing
Conway, SC 29526-9142
Other practice locations
- 1213 Elm St, Aynor, SC 29511-3320 · (843) 358-5806
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 1094 (SC) |
Medical Physician Assistant: Definition to come...
2 other providers at this address
Other medical physician assistant providers in Aynor
About NPI 1962466532
Ricky L. Kidman, PA-C's National Provider Identifier is 1962466532, issued on Apr 12, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Aynor, SC. The record was last updated on Aug 21, 2025.