Thomas    Fitzpatrick    MD
Contract Details
Athens-Limestone Hospital
Facility name
Provider ID
P000000543
NPI
1760492565
Tax ID
636002175
Effective Date
10/5/2000
Last Updated
7/16/2014
Direct Contract
Yes
Term Date
11/25/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
700 West Market Street
Athens, AL 35611
United States
County
Limestone
Phone
2562339292 (Phone)
Billing Details
Address
P.O. Box 999
Athens, AL 35612
Billing Phone
2562339292
Specialty Type
Surgery, Orthopedic
Map
Address