Lennie    Gibson    MD
Contract Details
BHC Snead
Facility name
Provider ID
P000000612
Tax ID
631094807
Effective Date
12/13/1994
Last Updated
2/4/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
180 Medical Street
Snead, AL 35952
United States
County
Etowah
Phone
2054667114 (Phone)
Billing Details
Address
P.O. Box 830605
Birmingham, AL 35283
Billing Phone
2054667114
Specialty Type
Family Practice
Map
Address