John  O  Mason  III  MD
Contract Details
Alabama Eye Services Network
Facility name
Provider ID
P000001069
NPI
1336124015
Tax ID
631120285
Effective Date
3/1/1999
Last Updated
4/17/2014
Direct Contract
Yes
Term Date
4/17/2014
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
700 18th Street South Suite 707
Birmingham, AL 35233
United States
County
Jefferson
Phone
2059180047 (Phone)
Billing Details
Address
P.O. Box 830778
Drawer 310
Birmingham, AL 35283
Billing Phone
2059180047
Specialty Type
Ophthalmology
Map
Address