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Gary
E
Kolb
DO
Contract Details
Bay Minette Family Practice
Facility name
Provider ID
P000000934
NPI
1851355846
Tax ID
631155098
Effective Date
9/1/1998
Last Updated
2/28/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
2305 Hand Avenue Suite 2
Bay Minette, AL 36507
United States
County
Baldwin
Phone
2519375652
(
Phone
)
Billing Details
Address
Specialty Type
Family Practice
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Address