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Donald
R
Ashley
Sr
MD
Contract Details
Afterhours Clinic
Facility name
Provider ID
P000000056
NPI
1093769036
Tax ID
630837891
Effective Date
3/1/2009
Last Updated
6/10/2016
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1800 Birmingham Avenue
Jasper, AL 35501
United States
County
Walker
Phone
2053844585
(
Phone
)
Billing Details
Address
P.O. Box 1287
Jasper, AL 35502
Specialty Type
Family Practice
Map
Address