William  D  Sudduth    MD
Contract Details
Southlake Orthopaedics--Brookwood Medical Center
Facility name
Provider ID
P000001690
NPI
1013954718
Tax ID
721353855
Effective Date
1/1/2006
Last Updated
12/9/2015
Direct Contract
Yes
Term Date
12/9/2015
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
513 Brookwood Boulevard Suite 402
Birmingham, AL 35209
United States
County
Jefferson
Phone
2058026898 (Phone)
Billing Details
Address
P.O. Box 830791
Birmingham, AL 35283
Billing Phone
2059854111
Specialty Type
Surgery, Orthopedic
Map
Address