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General NPI Number Information
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NPI Number | 1841510799
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Entity Type | Organization
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Legal Business Name | HUEY R KIDD DO PC
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Dates
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Enumeration Date | 06/02/2010
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Last Update Date | 01/08/2019
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Provider Practice Location Address
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Address Line | 218 MAIN STREET
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City | FULTON
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State | AL
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Zip | 36446
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Country | US
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Telephone | 334-636-4823
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Fax | 334-636-1702
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Provider Business Mailing Address
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Address Line | PO BOX 65
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City | FULTON
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State | AL
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Zip | 36446-0065
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Country | US
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Telephone | 334-636-4823
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Fax | 334-636-1702
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Authorized Official
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Title or Position | PHYSICIAN
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Name | HUEY R KIDD
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Credential | DO
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Telephone | 334-636-4823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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