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Douglas
S
Reynolds
MD
Contract Details
University Family Practice
Facility name
Provider ID
P000001450
NPI
1265537567
Tax ID
721396366
Effective Date
12/15/1999
Last Updated
9/12/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
904 Anna Avenue
Tuscaloosa, AL 35401
United States
County
Tuscaloosa
Phone
2053456960
(
Phone
)
Billing Details
Address
Specialty Type
Family Practice
Map
Address