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Louis
S
Allison
MD
Contract Details
Institute For Total Eye Care--Montgomery
Facility name
Provider ID
P000000024
Tax ID
630940618
Effective Date
10/1/2002
Last Updated
5/5/2014
Direct Contract
Yes
Term Date
5/29/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
4255 Carmichael Court North
Montgomery, AL 36106
United States
County
Montgomery
Phone
3342779111
(
Phone
)
Billing Details
Address
4255 Carmichael Court North
Montgomery, AL 36106
Billing Phone
3342779111
Specialty Type
Ophthalmology
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Address