Individual
DR. KELLY HYDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1108 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 793-5105
(334) 671-5073
Mailing address
1118 ROSS CLARK CIR, STUITE 700, DOTHAN, AL 36301-3001
(334) 793-5105
(334) 671-5073
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
00024277
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101292
—
AL
05
—
101294
—
AL
05
—
101302
—
AL
05
—
101309
—
AL
01
—
51548240
BCBS AL
AL
01
—
51548242
BCBS AL
AL
01
—
51548243
BCBS AL
AL
01
—
51548244
BCBS AL
AL
05
—
886096568A
—
GA
Enumeration date
11/17/2006
Last updated
07/17/2008
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