William  A  Roberts    MD
Contract Details
Bayside Orthopaedic, Sports Medicine & Rehabilitation Center
Facility name
Provider ID
P000001477
NPI
1962486977
Tax ID
630730089
Effective Date
6/1/1996
Last Updated
10/6/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
341 North Greeno Road
Fairhope, AL 36532
United States
County
Baldwin
Phone
2519282401 (Phone)
Billing Details
Address
P.O. Box 1186
Fairhope, AL 36533
Billing Phone
2519282401
Specialty Type
Surgery, Orthopedic
Map
Address