Contract Details
Facility name
Alabama Sports Medicine & Orthopaedic Center
Provider ID
P000001961
NPI
1487629101
Tax ID
621374727
Effective Date
8/5/1993
Last Updated
6/10/2016
Direct Contract
Term Date
4/3/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
105.00
Fee Schedule Multiplier
Location Details
Address
1201 11th Avenue South Suite 200
Birmingham, AL 35205
United States
County
Jefferson
Phone
2059393000 (Phone)
Billing Details
Address
P.O. Box 55487
Birmingham, AL 35255
Specialty Type
Surgery, Orthopedic
Map
Address