William  I  Park  IV  MD
Contract Details
The Orthopaedic Group, P.C.
Facility name
Provider ID
P000001317
NPI
1780642710
Tax ID
631187140
Effective Date
6/15/1999
Last Updated
12/15/2020
Direct Contract
Yes
Term Date
12/15/2020
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
6144 Airport Boulevard
Mobile, AL 36608
Specialty Type
Surgery, Orthopedic Foot
Map
Address