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Robert
P
Eichelberger
MD
Contract Details
ImageSouth Shelby
Facility name
Provider ID
P000000477
NPI
1427030642
Tax ID
651128122
Effective Date
12/1/2001
Last Updated
4/26/2017
Direct Contract
Yes
Term Date
4/19/2017
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
224 1st Street North Suite 150
Alabaster, AL 35007
United States
County
Shelby
Phone
2056634674
(
Phone
)
Billing Details
Address
P.O. Box 932545
Atlanta, GA 31193
Billing Phone
2059959899
Specialty Type
Radiology, Diagnostic
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Address