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Gordon
J
Kirschberg
MD
Contract Details
Southern Neurology
Facility name
Provider ID
P000000918
NPI
1588645535
Tax ID
630760539
Effective Date
5/1/1996
Last Updated
3/26/2014
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
2018 Brookwood Medical Center Drive Suite 302
Birmingham, AL 35209
United States
County
Jefferson
Phone
2058794200
(
Phone
)
Billing Details
Address
2018 Brookwood Medical Center Drive
Suite 302
Birmingham, AL 35209
Billing Phone
2058794200
Specialty Type
Surgery, Neurological
Map
Address