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David
P
McKinley
Sr
MD
Contract Details
Avalon Surgical
Facility name
Provider ID
P000001117
NPI
1043335151
Tax ID
630789637
Effective Date
11/9/1994
Last Updated
9/26/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
1120 South Jackson Highway Suite 307
Sheffield, AL 35660
United States
County
Colbert
Phone
2563810030
(
Phone
)
Billing Details
Address
Specialty Type
Surgery, General
Map
Address