Ronald Windell    Hanson    MD
Contract Details
DeKalb Regional Medical Center
Facility name
Provider ID
P000000707
NPI
1306834437
Tax ID
204370870
Effective Date
12/1/2008
Last Updated
6/13/2014
Direct Contract
Yes
Term Date
4/25/2013
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_011
Location Details
Address
310 South 5th Street
Gadsden, AL 35901
United States
County
Etowah
Phone
2565490650 (Phone)
Billing Details
Address
P.O. Box 277507
Atlanta, GA 30384
Billing Phone
2569972317
Specialty Type
Cardiovascular Disease
Map
Address