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Manuel
D
Rodriguez
DO
Contract Details
USA Health System
Facility name
Provider ID
P000001487
NPI
1376730408
Tax ID
630725648
Effective Date
9/25/2005
Last Updated
6/10/2016
Direct Contract
Yes
Term Date
7/10/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
575 Stanton Road
Mobile, AL 36617
United States
County
Mobile
Phone
2514717207
(
Phone
)
Billing Details
Address
P.O. Box 40480
Mobile, AL 36604
Specialty Type
Internal Medicine
Map
Address