Kevin  C  Staudinger    MD
Contract Details
Facility name
Provider ID
P000001663
NPI
1023111820
Tax ID
721383202
Effective Date
2/1/2006
Last Updated
6/9/2016
Direct Contract
Yes
Term Date
12/18/2012
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
833 Princeton Avenue Southwest
Birmingham, AL 35211
United States
County
Jefferson
Phone
2057812699 (Phone)
Billing Details
Address
200 Beacon Parkway West
Suite 330
Birmingham, AL 35211
Specialty Type
Occupational Medicine
Map
Address