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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
8/1/2018
Direct Contract
Yes
Term Date
7/29/2018
Status
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
4223 Orange Beach Boulevard Suite C
Orange Beach, AL 36561
United States
County
Baldwin
Phone
2519812663
(
Phone
)
Billing Details
Address
1505 Daphne Avenue
Daphne, AL 36526
Billing Phone
2516252663
Specialty Type
Surgery, Orthopedic
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Address