George  M  Taft    DO
Contract Details
Alabama Eye Services Network
Facility name
Provider ID
P000001703
NPI
1144274671
Tax ID
631080163
Effective Date
3/1/1999
Last Updated
4/17/2014
Direct Contract
Yes
Term Date
4/17/2014
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
201 Rosa Lane
Florence, AL 35630
United States
County
Lauderdale
Phone
2567608484 (Phone)
Billing Details
Address
P.O. Box 430
Killen, AL 35645
Billing Phone
2567608484
Specialty Type
Ophthalmology
Map
Address