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Nicholas
Gyles
MD
Contract Details
BHC--Craddock Health Center
Facility name
Provider ID
P000000674
Tax ID
631102587
Effective Date
12/13/1994
Last Updated
4/9/2014
Direct Contract
Yes
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
Surgery, General
Map
Address