Huey     Kidd    DO
Contract Details
Fulton Family Medical
Facility name
Provider ID
P000000001
NPI
1841510799
Tax ID
260483093
Effective Date
1/7/2022
Last Updated
1/20/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
218 Main Street
Fulton, AL 36446
United States
Phone
334-636-4823 (Phone)
Billing Details
Address
218 Main Street
Fulton, AL 36446
Billing Phone
334-636-4823
Specialty Type
Family Practice
Map
Address