Thomas  W  Irving    MD
Contract Details
Family Medical of Mobile--Tillman's Corner
Facility name
Provider ID
P000000824
NPI
1942252846
Tax ID
630942734
Effective Date
10/7/2022
Last Updated
11/9/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
5320 Highway 90 Service Road
Mobile, AL 36619
United States
County
Mobile
Phone
2516668232 (Phone)
Billing Details
Address
5320 Highway 90 Service Road
Mobile, AL 36619
Billing Phone
2516668232
Specialty Type
General Practice
Map
Address