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Laura
B
Kezar
MD
Contract Details
University of Alabama Health Services Foundation, P.C.
Facility name
Provider ID
P000000895
NPI
1922035872
Tax ID
630649108
Effective Date
1/1/1998
Last Updated
3/25/2014
Direct Contract
Yes
Term Date
3/14/2013
Status
W9 Attachment
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
UAB Highands 1201 11th Avenue South
Birmingham, AL 35205
United States
County
Jefferson
Phone
2059349999
(
Phone
)
Billing Details
Address
P.O. Box 55309
Birmingham, AL 35255
Billing Phone
2059349999
Specialty Type
Physical Medicine & Rehabilitation
Map
Address