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Contract Details
Facility name
Alabama Bone & Joint Clinic
Provider ID
P000001948
NPI
1780980540
Tax ID
274655689
Effective Date
1/1/1999
Last Updated
8/19/2014
Direct Contract
Yes
Term Date
3/5/2012
Status
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
48 Medical Park Drive East Suite 251
Birmingham, AL 35235
United States
County
Jefferson
Phone
2058383090
(
Phone
)
Billing Details
Address
48 Medical Park Drive East
Suite 251
Birmingham, AL 35235
Billing Phone
2058383090
Specialty Type
Rheumatology
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