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Bruce
Wasserman
MD
Contract Details
Alabama Eye Center
Facility name
Provider ID
P000001828
Tax ID
630813294
Effective Date
10/1/2002
Last Updated
5/5/2014
Direct Contract
Yes
Term Date
4/1/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
1109 20th Street
Haleyville, AL 35565
United States
County
Winston
Phone
2054868668
(
Phone
)
Billing Details
Address
20 Medical Center Drive
Suite 20
Jasper, AL 35501
Billing Phone
2052214705
Specialty Type
Ophthalmology
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Address