Provider Demographics
NPI:1568915106
Name:PHYSICIANS CARE OF GROVE HILL LLC
Entity Type:Organization
Organization Name:PHYSICIANS CARE OF GROVE HILL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HUEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:KIDD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:334-636-5311
Mailing Address - Street 1:127 CLARK ST STE C&D
Mailing Address - Street 2:
Mailing Address - City:GROVE HILL
Mailing Address - State:AL
Mailing Address - Zip Code:36451-3050
Mailing Address - Country:US
Mailing Address - Phone:334-636-5311
Mailing Address - Fax:334-636-2280
Practice Address - Street 1:127 CLARK ST STE C&D
Practice Address - Street 2:
Practice Address - City:GROVE HILL
Practice Address - State:AL
Practice Address - Zip Code:36451-3050
Practice Address - Country:US
Practice Address - Phone:334-636-5311
Practice Address - Fax:334-636-2280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-01
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health