Mark  R  McIlwain    DMD
Contract Details
Helen Keller Hospital
Facility name
Provider ID
P000001113
NPI
1720045685
Tax ID
630288825
Effective Date
7/15/2011
Last Updated
6/19/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_023
Location Details
Address
398 Ashe Boulevard
Sheffield, AL 35660
United States
County
Colbert
Phone
2563831499 (Phone)
Billing Details
Address
P.O. Box 610
Sheffield, AL 35660
Billing Phone
2563864005
Specialty Type
Surgery, Oral & Maxillofacial
Map
Address