Russell  L  Shoemaker    DO
Contract Details
Southeast Alabama Medical Center Clinics
Facility name
Provider ID
P000001601
NPI
1891702007
Tax ID
636004476
Effective Date
7/1/1995
Last Updated
8/6/2014
Direct Contract
Yes
Term Date
8/6/2014
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
Headland Medical Group 204 Homan Drive
Headland, AL 36345
United States
County
Henry
Phone
3346933336 (Phone)
Billing Details
Address
P.O. Box 218
Headland, AL 36345
Billing Phone
3346933336
Specialty Type
Family Practice
Map
Address