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Michael
P
Massey
MD
Contract Details
Retina Specialists of Alabama
Facility name
Provider ID
P000001071
NPI
1659300101
Tax ID
631248339
Effective Date
10/1/2002
Last Updated
5/5/2014
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
2055 Normandie Drive Suite 314
Montgomery, AL 36111
United States
County
Montgomery
Phone
3342630105
(
Phone
)
Billing Details
Address
P.O. Box 11984
Birmingham, AL 35202
Billing Phone
3342630105
Specialty Type
Ophthalmology
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Address