Donald  J  Derivaux    MD
Contract Details
Alabama Eye Services Network
Facility name
Provider ID
P000000425
NPI
1538145594
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
Specialty Type
Ophthalmology
Map
Address