Organization
PHYSICIANS CARE OF SWEET WATER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HUEY R KIDD DO (PHYSICIAN)
(334) 636-5311
Entity
Organization
Contact information
Practice address
31431 ALABAMA HIGHWAY 10, SWEET WATER, AL 36782-4936
(334) 636-5311
(334) 636-2280
Mailing address
31431 ALABAMA HIGHWAY 10, SWEET WATER, AL 36782-4936
(334) 636-5311
(334) 636-2280
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102G081345
MEDICARE PTAN
AL
Enumeration date
10/27/2011
Last updated
01/16/2019
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