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Cem
Cezayirli
MD
Contract Details
Haynes Neurosurgical Group
Facility name
Provider ID
P000000282
NPI
1518905116
Tax ID
630640018
Effective Date
5/15/2006
Last Updated
6/9/2016
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
801 Princeton Avenue Southwest Building 1, Suite 310
Birmingham, AL 35211
United States
County
Jefferson
Phone
2057878676
(
Phone
)
Billing Details
Address
801 Princeton Avenue Southwest
Building 1, Suite 310
Birmingham, AL 35211
Billing Phone
2057878676
Specialty Type
Surgery, Neurological
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Address