William  I  Park  III  MD
Contract Details
The Orthopaedic Group, P.C.
Facility name
Provider ID
P000001316
NPI
1194782334
Tax ID
631187140
Effective Date
6/15/1999
Last Updated
6/25/2013
Direct Contract
Yes
Term Date
6/25/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
6144 Airport Boulevard
Mobile, AL 36608
United States
County
Mobile
Phone
2514765050 (Phone)
Billing Details
Address
PO Box 86144
Mobile, AL 366896144
Specialty Type
Surgery, Orthopedic
Map
Address