Charles  H  Clark  III  MD
Contract Details
Neurosurgical Associates
Facility name
Provider ID
P000000309
NPI
1033206065
Tax ID
630576431
Effective Date
3/9/1992
Last Updated
8/16/2018
Direct Contract
Yes
Term Date
8/13/2018
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
800 St. Vincent's Drive Suite 700
Birmingham, AL 35205
United States
County
Jefferson
Phone
2059338981 (Phone)
Billing Details
Address
800 St. Vincent's Drive
Suite 700
Birmingham, AL 35205
Billing Phone
2059338981
Specialty Type
Surgery, Neurological
Map
Address