Jerry  L  Kitchens  Jr  MD
Contract Details
Surgical Associates
Facility name
Provider ID
P000000920
NPI
1609841550
Tax ID
630574926
Effective Date
8/31/2000
Last Updated
9/22/2014
Direct Contract
Term Date
8/14/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
860 Montclair Road Suite 758
Birmingham, AL 35213
United States
County
Jefferson
Phone
2059308020 (Phone)
Billing Details
Address
860 Montclair Road
Suite 758
Birmingham, AL 35213
Billing Phone
Specialty Type
Surgery, General
Map
Address