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Contract Details
University of Alabama Health Services Foundation, P.C.
Facility name
The Kirklin Clinic
Provider ID
P000002455
Tax ID
630649108
Effective Date
1/1/2005
Last Updated
10/23/2015
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
M
Exhibit ID
AM_172
AM_172
Location Details
Address
2000 6th Avenue South
Birmingham, AL 35233
United States
County
Jefferson
Phone
2058018000
(
Phone
)
Billing Details
Address
P.O. Box 55309
Birmingham, AL 35255
Billing Phone
2058018000
Specialty Type
Multi-Specialty Practice
Map
Address