James  O  Devaney  Jr  MD
Contract Details
Hand Avenue Family Practice
Facility name
Provider ID
P000000428
NPI
1124188610
Tax ID
631155095
Effective Date
9/1/1998
Last Updated
12/12/2013
Direct Contract
Yes
Term Date
12/12/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
2002 McMillan Avenue
Bay Minette, AL 36507
United States
County
Baldwin
Phone
2519377796 (Phone)
Billing Details
Address
Specialty Type
Family Practice
Map
Address