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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
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
2305 Hand Avenue
Bay Minette, AL 36507
United States
County
Baldwin
Phone
2515803526
(
Phone
)
Billing Details
Address
1505 Daphne Avenue
Daphne, AL 36526
Billing Phone
2516252663
Specialty Type
Surgery, Orthopedic
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Address