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J Markus
Carter
DO
Contract Details
Facility name
Provider ID
P000000266
NPI
1659379733
Tax ID
621374727
Effective Date
8/5/1993
Last Updated
6/10/2016
Direct Contract
Yes
Term Date
4/3/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
105.00
Fee Schedule Multiplier
Location Details
Address
805 St. Vincent's Drive Suite 100
Birmingham, AL 35255
United States
County
Jefferson
Phone
2059393000
(
Phone
)
Billing Details
Address
P.O. Box 55487
Birmingham, AL 35255
Specialty Type
Physical Medicine & Rehabilitation
Map
Address