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
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
101 East 15th Avenue
Gulf Shores, AL 36542
United States
County
Baldwin
Phone
2514765050 (Phone)
Billing Details
Address
P.O. Box 86144
Mobile, AL 36689
Billing Phone
2514765050
Specialty Type
Surgery, Orthopedic
Map
Address