Danny    Sailsbury    DO
Contract Details
Southeastern Pain Management
Facility name
Provider ID
P000001533
NPI
1841345808
Tax ID
721398641
Effective Date
12/1/2006
Last Updated
8/19/2014
Direct Contract
Yes
Term Date
4/23/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1026 Goodyear Avenue Suite 302
Gadsden, AL 35903
United States
County
Etowah
Phone
2564927246 (Phone)
Billing Details
Address
1026 Goodyear Avenue
Suite 302
Gadsden, AL 35903
Billing Phone
2564927246
Specialty Type
Pain Medicine
Map
Address