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Kent
C
Keys
MD
Contract Details
Alabama Eye Services Network
Facility name
Provider ID
P000000894
NPI
1760572960
Tax ID
631163211
Effective Date
3/1/1999
Last Updated
6/10/2014
Direct Contract
Yes
Term Date
11/21/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
1029 Christine Avenue
Anniston, AL 36207
United States
County
Calhoun
Phone
2562370371
(
Phone
)
Billing Details
Address
P.O. Box 970
Anniston, AL 36202
Billing Phone
2562370371
Specialty Type
Ophthalmology
Map
Address