Gary  M  Fowler    MD
Contract Details
Carraway Family Medicine
Facility name
Provider ID
P000000563
NPI
1073503405
Tax ID
630935084
Effective Date
9/21/1998
Last Updated
6/10/2016
Direct Contract
Yes
Term Date
1/1/2008
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
191 Carraway Drive
Winfield, AL 35594
United States
County
Fayette
Phone
2054871586 (Phone)
Billing Details
Address
P.O. Box 548
Winfield, AL 35594
Specialty Type
Family Practice
Map
Address