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Jeremy
W
Amps
MD
Contract Details
Pinnacle Brain and Spine Center
Facility name
Provider ID
P000000034
NPI
1093810574
Tax ID
202719929
Effective Date
11/15/2007
Last Updated
8/29/2014
Direct Contract
Yes
Term Date
9/19/2013
Status
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
6701 Airport Boulevard Suite D-146
Mobile, AL 36608
United States
County
Mobile
Phone
2516335155
(
Phone
)
Billing Details
Address
6701 Airport Boulevard
Suite D-146
Mobile, AL 36608
Billing Phone
2516335155
Specialty Type
Surgery, Neurological
Map
Address