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Thomas
L
Horton
MD
Contract Details
DeKalb Regional Medical Center
Facility name
Provider ID
P000000786
NPI
1972531127
Tax ID
204370870
Effective Date
12/1/2008
Last Updated
6/13/2014
Direct Contract
Yes
Term Date
6/13/2014
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_011
AM_011
Location Details
Address
421 Medical Center Drive Southwest
Fort Payne, AL 35968
United States
County
De Kalb
Phone
2568451401
(
Phone
)
Billing Details
Address
P.O. Box 277507
Atlanta, GA 30384
Billing Phone
2569972317
Specialty Type
Family Practice
Map
Address