Contract Details
Facility name
The Orthopaedic Group
Provider ID
P000002461
NPI
1164489951
Tax ID
631187140
Effective Date
6/15/1999
Last Updated
9/3/2015
Direct Contract
Yes
Term Date
6/25/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
859 Winter Street
Lucedale, MS 39452
United States
County
George
Phone
2514765050 (Phone)
Billing Details
Address
P.O. Box 86144
Mobile, AL 36689
Billing Phone
Specialty Type
Surgery, Orthopedic
Map
Address