Address: 1948 Highway 157 Building 1, Suite 430, Cullman, 35055, United States
Telephone: 2567372540

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

State Fee Schedule Multiplier

90.00

Location Details

Address

1948 Highway 157 Building 1, Suite 430

Cullman, AL 35055

United States

County

Cullman

Phone

2567372540 (Phone)

Billing Details

Address

800 Saint Vincent's Drive

Suite 700

Birmingham, AL 35205

Billing Phone

Specialty Type

Surgery, Neurological

Map