Hisham    Hakim    MD
Contract Details
Greystone Neurology
Facility name
Provider ID
P000000680
NPI
1891887535
Tax ID
631111494
Effective Date
7/15/1994
Last Updated
2/9/2017
Direct Contract
Yes
Term Date
2/8/2017
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
202 Medical Park
Talladega, AL 35160
United States
County
Talladega
Phone
2563621170 (Phone)
Billing Details
Address
7500 Hugh Daniel Drive
Suite 250
Birmingham, AL 35242
Billing Phone
2059913300
Specialty Type
Neurology
Map
Address