Khalid  L  Khan    MD
Contract Details
Alabama Eye Services Network
Facility name
Provider ID
P000000896
NPI
1538168810
Tax ID
630733593
Effective Date
3/1/1999
Last Updated
5/5/2014
Direct Contract
Yes
Term Date
11/22/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
40745 Highway 77
Ashland, AL 36251
United States
County
Clay
Phone
2563543155 (Phone)
Billing Details
Address
216 East Battle Street
Suite A
Talladega, AL 35160
Billing Phone
2563543155
Specialty Type
Ophthalmology
Map
Address