Thomas  R  Syverson    MD
Contract Details
Syverson Medical Group
Facility name
Provider ID
P000001701
NPI
1750366290
Tax ID
271331887
Effective Date
2/15/2010
Last Updated
6/10/2016
Direct Contract
Yes
Term Date
12/31/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1400 North McKenzie Street
Foley, AL 36535
United States
County
Baldwin
Phone
2514241200 (Phone)
Billing Details
Address
P.O. Box 8159
Mobile, AL 36689
Specialty Type
Pain Medicine
Map
Address