Virginia  R  Lolley    MD
Contract Details
UAB Department of Ophthalmology
Facility name
Provider ID
P000001006
NPI
1477556991
Tax ID
631206956
Effective Date
10/1/2002
Last Updated
5/5/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
700 18th Street South Suite 601
Birmingham, AL 35233
United States
County
Jefferson
Phone
2053258620 (Phone)
Billing Details
Address
P.O. Box 830941
Birmingham, AL 35283
Billing Phone
2053258620
Specialty Type
Ophthalmology
Map
Address