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Benjamin
B
Bailey
MD
Contract Details
Russell Medical Center
Facility name
Provider ID
P000000071
NPI
1386680965
Tax ID
630385130
Effective Date
3/1/1999
Last Updated
6/10/2014
Direct Contract
Yes
Term Date
7/25/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
3316 Highway 280
Alexander City, AL 35010
United States
County
Tallapoosa
Phone
2563297100
(
Phone
)
Billing Details
Address
P.O. Box 939
Alexander City, AL 35011
Billing Phone
2563297109
Specialty Type
Emergency Medicine
Map
Address