John  B  Blalock  Jr  MD
Contract Details
John B. Blalock, Jr., M.D., P.C.
Facility name
Provider ID
P000000150
NPI
1063685352
Tax ID
631057204
Effective Date
2/1/1999
Last Updated
4/16/2014
Direct Contract
Term Date
12/17/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
2660 10th Avenue South Suite 238
Birmingham, AL 35205
United States
County
Jefferson
Phone
2059337301 (Phone)
Billing Details
Address
2660 10th Avenue South
Suite 238
Birmingham, AL 35205
Billing Phone
Specialty Type
Surgery, General
Map
Address