Jason  C  Swanner    MD
Contract Details
Helen Keller Hospital
Facility name
Provider ID
P000001695
NPI
1679593719
Tax ID
630288825
Effective Date
7/15/2011
Last Updated
5/5/2014
Direct Contract
Yes
Term Date
1/13/2014
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_023
Location Details
Address
646 Cox Creek Parkway Suite A
Florence, AL 35631
United States
County
Lauderdale
Phone
2567601771 (Phone)
Billing Details
Address
P.O. Box 610
Sheffield, AL 35660
Billing Phone
2563864005
Specialty Type
Ophthalmology
Map
Address