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Contract Details
Facility name
Southern Orthopaedic Surgeons, LLC
Provider ID
P000002426
NPI
1861432239
Tax ID
631178354
Effective Date
11/6/2000
Last Updated
5/21/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2119 East South Boulevard Suite 200
Montgomery, AL 36116
United States
County
Montgomery
Phone
3346139000
(
Phone
)
Billing Details
Address
P.O. Box 250450
Montgomery, AL 36125
Billing Phone
3346139000
Specialty Type
Surgery, Orthopedic
Map
Address