Contract Details
Facility name
Dothan Surgery Center
Provider ID
P000002087
NPI
1003815242
Tax ID
631267139
Effective Date
4/2/2001
Last Updated
12/2/2013
Direct Contract
Yes
Term Date
9/12/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
1450 Ross Clark Circle Suite 4
Dothan, AL 36301
United States
County
Houston
Phone
3347933442 (Phone)
Billing Details
Address
Specialty Type
Ambulatory Surgical Facility
Map
Address