Contract Details
Facility name
Retina Associates of Alabama
Provider ID
P000002372
NPI
1124042601
Tax ID
202354132
Effective Date
6/1/2006
Last Updated
5/5/2014
Direct Contract
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
160 Healthwest Drive
Dothan, AL 36303
United States
County
Houston
Phone
3347121700 (Phone)
Billing Details
Address
P.O. Box 8008
Dothan, AL 36304
Billing Phone
Specialty Type
Ophthalmology
Map
Address