William Scott    Lynn    MD
Contract Details
Madison Open MRI
Facility name
Provider ID
P000001029
NPI
1710097399
Tax ID
201652810
Effective Date
4/15/2005
Last Updated
8/29/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
540 Hughes Road Suite 5
Madison, AL 35758
United States
County
Madison
Phone
2564618808 (Phone)
Billing Details
Address
P.O. Box 933108
Atlanta, GA 31193
Billing Phone
2059959899
Specialty Type
Neuroradiology
Map
Address