Contract Details
NWMC-Winfield Physician Practices, LLC
Facility name
Sulligent Medical Clinic
Provider ID
P000002227
NPI
1881775914
Tax ID
472498379
Effective Date
2/21/2001
Last Updated
2/20/2020
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
1390 Walnut Street
Sulligent, AL 35586
United States
County
Lamar
Phone
2056987111 (Phone)
Billing Details
Address
1390 Walnut Street
Sulligent, AL 35586
Billing Phone
2056987111
Specialty Type
Family Practice
Map
Address