Charles Michael    Mead    MD
Contract Details
North Jefferson Imaging
Facility name
Provider ID
P000001130
NPI
1205833761
Tax ID
203669979
Effective Date
3/1/2007
Last Updated
6/11/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2217 Decatur Highway Suite 115
Gardendale, AL 35071
United States
County
Jefferson
Phone
2054181280 (Phone)
Billing Details
Address
2000-A Southbridge Parkway
Suite 300
Birmingham, AL 35209
Billing Phone
2058714274
Specialty Type
Radiology, Diagnostic
Map
Address