Elizabeth  G  Mathison    MD
Contract Details
IMC - Mobile Family Physicians, PC
Facility name
Provider ID
P000001073
NPI
1750398434
Tax ID
630650216
Effective Date
8/18/1996
Last Updated
11/21/2011
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
1924 Dauphin Island Pkwy Suite K
Mobile, AL 36605
United States
County
Mobile
Phone
2514766330 (Phone)
Billing Details
Address
Specialty Type
Family Practice
Map
Address