Michael  K  Gray    MD
Contract Details
Helen Keller Hospital
Facility name
Provider ID
P000000647
NPI
1457322877
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
416 North Seminary Street
Florence, AL 35630
United States
County
Lauderdale
Phone
2567645351 (Phone)
Billing Details
Address
P.O. Box 610
Sheffield, AL 35660
Billing Phone
2563864005
Specialty Type
Ophthalmology
Map
Address