Vijay Laxmi    Misra    MD
Contract Details
University of Alabama Health Services Foundation, P.C.
Facility name
Provider ID
P000001172
NPI
1164475877
Tax ID
630649108
Effective Date
4/1/1996
Last Updated
3/26/2014
Direct Contract
Yes
Term Date
3/15/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
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
Gastroenterology
Map
Address