S. Wayne    Taylor  Jr  MD
Contract Details
Retina & Vitreous Associates of Alabama, P.C.
Facility name
Provider ID
P000001717
NPI
1568491017
Tax ID
631159547
Effective Date
10/25/1996
Last Updated
6/10/2016
Direct Contract
Term Date
8/14/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
408 Paul W. Bryant Drive East Building A
Tuscaloosa, AL 35401
United States
County
Tuscaloosa
Phone
2053430003 (Phone)
Billing Details
Address
P.O. Box 10992
Birmingham, AL 35202
Specialty Type
Ophthalmology
Map
Address