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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
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Address