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James
Poteet
MD
Contract Details
Infirmary Occupational Health--Mobile-Water Street
Facility name
Provider ID
P000001382
Tax ID
631056697
Effective Date
8/18/1992
Last Updated
4/21/2015
Direct Contract
Yes
Term Date
4/21/2015
Status
W9 Attachment
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
305 North Water Street
Mobile, AL 36602
United States
County
Mobile
Phone
2514333781
(
Phone
)
Billing Details
Address
P.O. Box 322
Mobile, AL 36601
Specialty Type
General Practice
Map
Address