Contract Details
Facility name
Southern Bone & Joint Specialists
Provider ID
P000002418
NPI
1134106065
Tax ID
200870135
Effective Date
7/1/1998
Last Updated
5/21/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
1500 Ross Clark Circle
Dothan, AL 36301
United States
County
Houston
Phone
3347932663 (Phone)
Billing Details
Address
P.O. Box 729
Dothan, AL 36302
Billing Phone
3347932663
Specialty Type
Surgery, Orthopedic
Map
Address