Bry  H  Coburn    MD
Contract Details
Alabama Eye Services Network
Facility name
Provider ID
P000000317
NPI
1831171024
Tax ID
630600032
Effective Date
3/1/1999
Last Updated
5/5/2014
Direct Contract
Yes
Term Date
3/17/2014
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
833 Saint Vincent's Drive Suite 207
Birmingham, AL 35205
United States
County
Jefferson
Phone
2059331380 (Phone)
Billing Details
Address
833 St. Vincent's Drive
Suite 207
Birmingham, AL 35205
Billing Phone
2059331380
Specialty Type
Ophthalmology
Map
Address