Huey    Kidd    DO
Contract Details
Physicians Care of Clarke
Facility name
Provider ID
P000000001
NPI
1265427090
Tax ID
832589567
Effective Date
12/22/2021
Last Updated
12/28/2021
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
127 Clark Street
Grove Hill, AL 36451
United States
Phone
251-275-1274 (Phone)
Billing Details
Address
127 Clark Street
Grove Hill, AL 36451
Billing Phone
251-275-1274
Specialty Type
Family Practice
Map
Address