James  A  Kimble    MD
Contract Details
Retina Specialists of Alabama
Facility name
Provider ID
P000000904
NPI
1285663732
Tax ID
631248339
Effective Date
10/1/2002
Last Updated
5/5/2014
Direct Contract
Yes
Term Date
7/22/2013
Status
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
Map
Address