Contract Details
Facility name
Alabama Orthopaedic Clinic, PC
Provider ID
P000001953
NPI
1487720355
Tax ID
631174582
Effective Date
7/1/2005
Last Updated
5/21/2017
Direct Contract
Term Date
4/16/2015
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
220 Hospital Avenue
Jackson, AL 36545
United States
County
Clarke
Phone
2514103600 (Phone)
Billing Details
Address
3610 Springhill Memorial Drive North
Mobile, AL 36608
Billing Phone
Specialty Type
Surgery, Orthopedic
Map
Address