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Contract Details
Facility name
Brookwood Orthopedics
Provider ID
P000002028
NPI
1356362412
Tax ID
850488403
Effective Date
7/1/2004
Last Updated
6/6/2014
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
3105 Independence Drive Suite 105
Birmingham, AL 35209
United States
County
Jefferson
Phone
2058701498
(
Phone
)
Billing Details
Address
3105 Independence Drive
Suite 105
Birmingham, AL 35209
Billing Phone
2058701498
Specialty Type
Surgery, Orthopedic
Map
Address