| Charles Alexander Kidd, MD | |
|
207 Elk Ave S, Fayetteville, TN 37334-3051 | |
| (931) 433-2551 | |
| (931) 438-0069 |
| Full Name | Charles Alexander Kidd |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 10 Years |
| Location | 207 Elk Ave S, Fayetteville, Tennessee |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396126165 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 38504 (South Carolina) | Secondary |
| 208000000X | Pediatrics | 38504 (South Carolina) | Secondary |
| 207R00000X | Internal Medicine | 56894 (Tennessee) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Quality First Home Care | Columbia, TN | Home health agency |
| Lincoln Medical Home Health And Hospice | Fayetteville, TN | Home health agency |
| Lincoln Medical Center | Fayetteville, TN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hh Health System - Lincoln Inc | 3971987900 | 11 |
| Entity Name | Hh Physician Care-fayetteville Medical Associates |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225574056 PECOS PAC ID: 1850662651 Enrollment ID: O20170811001033 |
| Entity Name | Hh Health System - Lincoln Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740914324 PECOS PAC ID: 3971987900 Enrollment ID: O20220915000695 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Alexander Kidd, MD 1 Independence Pt Ste 212, Resident Enrollment, Greenville, SC 29615-4536 Ph: (864) 455-7844 | Charles Alexander Kidd, MD 207 Elk Ave S, Fayetteville, TN 37334-3051 Ph: (931) 433-2551 |
Dr. Samuel Michael Ashby, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 804 William D Jones Blvd, Fayetteville, TN 37334 Phone: 931-438-1435 | |
Yashwant P Patel, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 207 Elk Ave S, Fayetteville, TN 37334 Phone: 931-433-2551 Fax: 931-433-1142 |