Contract Details
Facility name
Alabama Orthopaedic Clinic, PC
Provider ID
P000001952
NPI
1508931866
Tax ID
631174582
Effective Date
7/1/2005
Last Updated
6/28/2018
Direct Contract
Yes
Term Date
7/25/2005
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
14600 Saint Stevens Avenue
Chatom, AL 36518
United States
County
Washington
Phone
2514103600 (Phone)
Billing Details
Address
3610 Springhill Memorial Drive North
Mobile, AL 36608
Billing Phone
2514103600
Specialty Type
Surgery, Orthopedic
Map
Address