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John
A
Higginbotham
MD
Contract Details
SportsMed Orthopaedic Surgery & Spine Center
Facility name
Provider ID
P000000756
NPI
1326089905
Tax ID
631262177
Effective Date
9/19/1994
Last Updated
5/20/2013
Direct Contract
Yes
Term Date
1/1/2012
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
4715 Whitesburg Drive
Huntsville, AL 35802
United States
County
Madison
Phone
2568815151
(
Phone
)
Billing Details
Address
Specialty Type
Surgery, Orthopedic
Map
Address