Contract Details
Facility name
Baldwin Bone & Joint, PC
Provider ID
P000007576
NPI
1790714459
Tax ID
631283588
Effective Date
10/1/2001
Last Updated
5/21/2017
Direct Contract
Yes
Term Date
12/12/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
1505 Daphne Avenue
Daphne, AL 36526
United States
County
Baldwin
Phone
2516252663 (Phone)
Billing Details
Address
1505 Daphne Avenue
Daphne, AL 36526
Billing Phone
2516252663
Specialty Type
Surgery, Orthopedic
Map
Address