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Huey
Kidd
DO
Contract Details
Physicians Care of Clarke
Facility name
Provider ID
P000000001
NPI
1548937923
Tax ID
832589567
Effective Date
12/22/2021
Last Updated
12/28/2021
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
24B Camden Bypass
Camden, AL 36726
United States
Phone
334-682-9050
(
Phone
)
Billing Details
Address
24B Camden Bypass
Camden, AL 36726
Billing Phone
334-682-9050
Specialty Type
Family Practice
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