Pamela    Kulback    MD
Contract Details
Open MRI of Jasper
Facility name
Provider ID
P000000950
NPI
1942282173
Tax ID
202513140
Effective Date
3/1/2006
Last Updated
6/10/2016
Direct Contract
Term Date
6/24/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
301 North Walston Bridge Road Suite 104
Jasper, AL 35504
United States
County
Walker
Phone
2053870977 (Phone)
Billing Details
Address
P.O. Box 2153
Department 5111
Birmingham, AL 35287
Specialty Type
Radiology, Diagnostic
Map
Address