William  L  Poole  Jr  MD
Contract Details
BHC--Craddock Health Center
Facility name
Provider ID
P000001378
NPI
1689768798
Tax ID
631102587
Effective Date
12/13/1994
Last Updated
4/9/2014
Direct Contract
Term Date
4/9/2014
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
209 West Spring Street Suite 200
Sylacauga, AL 35150
United States
County
Talladega
Phone
2562455241 (Phone)
Billing Details
Address
Specialty Type
Dermatology
Map
Address