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Wayne
P
Hyatt
Jr
MD
Contract Details
Eastern Medical Eye Center
Facility name
Provider ID
P000000817
NPI
1548261498
Tax ID
721384996
Effective Date
10/1/2002
Last Updated
5/5/2014
Direct Contract
Yes
Term Date
5/7/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
52 Medical Park Drive East Suite 211
Birmingham, AL 35235
United States
County
Jefferson
Phone
2058383696
(
Phone
)
Billing Details
Address
52 Medical Park Drive East
Suite 211
Birmingham, AL 35235
Billing Phone
2058383696
Specialty Type
Ophthalmology
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Address