George  A  Evans    MD
Contract Details
Shoals Medical Clinic
Facility name
Provider ID
P000000512
NPI
1124073788
Tax ID
631117251
Effective Date
2/1/2003
Last Updated
8/26/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1404 East Avalon Avenue Suite B
Tuscumbia, AL 35674
United States
County
Colbert
Phone
2563838804 (Phone)
Billing Details
Address
Specialty Type
Family Practice
Map
Address