William  E  Mock    MD
Contract Details
Alabama Eye Services Network
Facility name
Provider ID
P000001176
NPI
1508879925
Tax ID
630691977
Effective Date
3/1/1999
Last Updated
12/3/2013
Direct Contract
Yes
Term Date
12/3/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
121 North 20th Street Building 26
Opelika, AL 36801
United States
County
Lee
Phone
3347491486 (Phone)
Billing Details
Address
Specialty Type
Ophthalmology
Map
Address