Glenn  L  Wilson    MD
Contract Details
Gadsden Orthopedics
Facility name
Provider ID
P000001884
NPI
1750479754
Tax ID
630650229
Effective Date
10/25/2000
Last Updated
5/14/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
100 Medical Center Drive Suite 101
Gadsden, AL 35903
United States
County
Etowah
Phone
2564928590 (Phone)
Billing Details
Address
Specialty Type
Surgery, Orthopedic
Map
Address