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James
A
Kimble
MD
Contract Details
Retina & Vitreous Associates of Alabama, P.C.
Facility name
Provider ID
P000000904
NPI
1285663732
Tax ID
631159547
Effective Date
10/25/1996
Last Updated
6/10/2016
Direct Contract
Yes
Term Date
8/14/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
401 Meridian Street Suite 400
Huntsville, AL 35801
United States
County
Madison
Phone
2565398851
(
Phone
)
Billing Details
Address
P.O. Box 10992
Birmingham, AL 35202
Specialty Type
Ophthalmology
Map
Address