Thomas  B  Montgomery    MD
Contract Details
USA Health System
Facility name
Provider ID
P000001181
NPI
1639117492
Tax ID
630725648
Effective Date
9/25/2005
Last Updated
6/10/2016
Direct Contract
Yes
Status
Active
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