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Lucie
M
King
MD
Contract Details
Facility name
Provider ID
P000000906
NPI
1902896509
Tax ID
630860376
Effective Date
8/19/1992
Last Updated
6/10/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
701 University Boulevard East Suite 602
Tuscaloosa, AL 35401
United States
County
Tuscaloosa
Phone
2057586611
(
Phone
)
Billing Details
Address
P.O. Box 2689
Tuscaloosa, AL 35403
Specialty Type
Surgery, Hand
Map
Address