Kevin McClain    Cottingham    MD
Contract Details
Birmingham Surgical
Facility name
Provider ID
P000000349
NPI
1043279797
Tax ID
630677675
Effective Date
12/15/2006
Last Updated
3/26/2014
Direct Contract
Yes
Term Date
4/17/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
833 Princeton Avenue Southwest POB III, Suite 200-A
Birmingham, AL 35211
United States
County
Jefferson
Phone
2057863096 (Phone)
Billing Details
Address
2022 Brookwood Medical Center Drive
Suite 313
Birmingham, AL 35209
Billing Phone
Specialty Type
Surgery, General
Map
Address