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
295 South Jackson Street Suite C
Grove Hill, AL 36451
United States
County
Clarke
Phone
2514765050 (Phone)
Billing Details
Address
P.O. Box 86144
Mobile, AL 36689
Billing Phone
2564765050
Specialty Type
Surgery, Orthopedic
Map
Address