George  L  Kirkpatrick    MD
Contract Details
IMC - Daphne
Facility name
Provider ID
P000000917
NPI
1457430753
Tax ID
721398998
Effective Date
9/1/1998
Last Updated
11/21/2011
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
7101 Hwy 90 Suite 101
Daphne, AL 36526
United States
County
Baldwin
Phone
2516258222 (Phone)
Billing Details
Address
Specialty Type
Emergency Medicine
Map
Address