Craig  R  Peterson    MD
Contract Details
Thomas Hospital
Facility name
Provider ID
P000001351
NPI
1619923844
Tax ID
630891904
Effective Date
7/1/1995
Last Updated
6/30/2014
Direct Contract
Yes
Term Date
6/30/2014
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_036
Location Details
Address
750 Morphy Avenue
Fairhope, AL 36532
United States
County
Baldwin
Phone
2519282375 (Phone)
Billing Details
Address
P.O. Box 929
Fairhope, AL 36533
Billing Phone
Specialty Type
Cardiology
Map
Address