Terry  W  Taylor    MD
Contract Details
Coastal Neurological Institute
Facility name
Provider ID
P000001716
NPI
1245381409
Tax ID
630782200
Effective Date
4/1/2010
Last Updated
6/30/2014
Direct Contract
Yes
Term Date
4/22/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
2203 Perimeter Road
Mobile, AL 36615
United States
County
Mobile
Phone
2514346770 (Phone)
Billing Details
Address
3280 Dauphin Street
Building A
Mobile, AL 36606
Billing Phone
2514503700
Specialty Type
Occupational Medicine
Map
Address