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Estopinal
MD
Contract Details
Alabama Eye Services Network
Facility name
Provider ID
P000000509
NPI
1215033154
Tax ID
631205578
Effective Date
3/1/1999
Last Updated
5/5/2014
Direct Contract
Yes
Term Date
5/5/2014
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
401 Meridian Street Suite 200
Huntsville, AL 35801
United States
County
Madison
Phone
2565333210
(
Phone
)
Billing Details
Address
401 Meridian Street
Suite 200
Huntsville, AL 35801
Billing Phone
2565333210
Specialty Type
Ophthalmology
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Address