Thomas  A  Gibson    MD
Contract Details
Valley Radiology
Facility name
Provider ID
P000000613
NPI
1609986553
Tax ID
630630858
Effective Date
12/1/1993
Last Updated
9/13/2013
Direct Contract
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
1108 South Broad Street
Scottsboro, AL 35768
United States
County
Jackson
Phone
2562592323 (Phone)
Billing Details
Address
Specialty Type
Radiology, Diagnostic
Map
Address