Mark  A  Elkus    MD
Contract Details
Orthopedic Group of Birmingham
Facility name
Provider ID
P000000486
NPI
1366515033
Tax ID
630736962
Effective Date
9/1/2005
Last Updated
3/26/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1400 19th Street South
Birmingham, AL 35205
United States
County
Jefferson
Phone
2059390610 (Phone)
Billing Details
Address
P.O. Box 55395
Birmingham, AL 35255
Billing Phone
2059390610
Specialty Type
Surgery, Orthopedic
Map
Address