Eric    Roth    MD
Contract Details
Occupational Health Group--Huntsville
Facility name
Provider ID
P000001505
NPI
1700935608
Tax ID
260811369
Effective Date
10/1/2000
Last Updated
9/2/2015
Direct Contract
Yes
Term Date
9/2/2015
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_251
Location Details
Address
1963 Memorial Parkway Southwest Suite 24
Huntsville, AL 35801
United States
County
Madison
Phone
2562657000 (Phone)
Billing Details
Address
P.O. Box 7187
Huntsville, AL 35807
Billing Phone
2562657000
Specialty Type
Occupational Medicine
Map
Address