Jason  P  Lockette    MD
Contract Details
Helen Keller Hospital
Facility name
Provider ID
P000001002
NPI
1437246600
Tax ID
630288825
Effective Date
7/15/2011
Last Updated
6/19/2014
Direct Contract
Yes
Term Date
1/13/2014
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_023
Location Details
Address
1106 North Cave Street
Tuscumbia, AL 35674
United States
County
Colbert
Phone
2563146673 (Phone)
Billing Details
Address
P.O. Box 610
Sheffield, AL 35660
Billing Phone
2563864005
Specialty Type
Otolaryngology
Map
Address