Terry  L  Dawson    MD
Contract Details
Alabama Eye Services Network
Facility name
Provider ID
P000000405
NPI
1194821132
Tax ID
630809875
Effective Date
3/1/1999
Last Updated
5/5/2014
Direct Contract
Yes
Term Date
12/31/2011
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
1800 Highway 157 POB 3, Suite 201
Cullman, AL 35055
United States
County
Cullman
Phone
2567365507 (Phone)
Billing Details
Address
1800 Highway 157
POB 3, Suite 201
Cullman, AL 35055
Billing Phone
2567365507
Specialty Type
Ophthalmology
Map
Address