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Elaine
K
Thompson
OD
Contract Details
Alabama Eye Services Network
Facility name
Provider ID
P000001736
NPI
1720060320
Tax ID
630906950
Effective Date
3/1/1999
Last Updated
4/14/2014
Direct Contract
Yes
Term Date
12/31/2002
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
700 18th Street South Suite 511
Birmingham, AL 35233
United States
County
Jefferson
Phone
2059336888
(
Phone
)
Billing Details
Address
700 18th Street South
Suite 511
Birmingham, AL 35233
Billing Phone
2059336888
Specialty Type
Optometry
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Address