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Charles
S
Tompkins
MD
Contract Details
Family Practice Associates, LLC
Facility name
Provider ID
P000001754
NPI
1760418438
Tax ID
630960121
Effective Date
12/15/2001
Last Updated
5/10/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
1704 South Forest Avenue
Luverne, AL 36049
United States
County
Crenshaw
Phone
3343353383
(
Phone
)
Billing Details
Address
Specialty Type
Family Practice
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Address