J Clay    Rainer    MD
Contract Details
Bayside Orthopaedic, Sports Medicine & Rehabilitation Center
Facility name
Provider ID
P000001444
Tax ID
630730089
Effective Date
6/1/1996
Last Updated
4/21/2020
Direct Contract
No
Term Date
4/14/2020
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
341 North Greeno Road
Fairhope, AL 36532
Billing Phone
2519282401
Specialty Type
Surgery, Orthopedic
Map
Address