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Contract Details
Facility name
Alabama Orthopaedic Clinic, PC
Provider ID
P000001951
NPI
1306846654
Tax ID
631174582
Effective Date
7/1/2005
Last Updated
6/28/2018
Direct Contract
Yes
Term Date
6/25/2018
Status
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
3610 Springhill Memorial Drive North
Mobile, AL 36608
United States
County
Mobile
Phone
2514103600
(
Phone
)
Billing Details
Address
3610 Springhill Memorial Drive North
Mobile, AL 36608
Billing Phone
2514103600
Specialty Type
Physical Therapy
Map
Address