James Randall    Pitts    MD
Contract Details
Alabama Eye Services Network
Facility name
Provider ID
P000001369
NPI
1952317364
Tax ID
630862256
Effective Date
3/1/1999
Last Updated
5/5/2014
Direct Contract
Term Date
12/31/2002
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
613 1st Street North
Alabaster, AL 35007
United States
County
Shelby
Phone
2056202292 (Phone)
Billing Details
Address
613 1st Street North
Alabaster, AL 35007
Billing Phone
Specialty Type
Ophthalmology
Map
Address