Vishal  C  Patel    MD
Contract Details
Southeast Alabama Medical Center
Facility name
Provider ID
P000001333
NPI
1255542262
Tax ID
636004476
Effective Date
3/15/1995
Last Updated
8/6/2014
Direct Contract
Yes
Term Date
8/6/2014
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_051
Location Details
Address
1108 Ross Clark Circle
Dothan, AL 36301
United States
County
Houston
Phone
3347938111 (Phone)
Billing Details
Address
P.O. Box 6987
Dothan, AL 36302
Billing Phone
3347938111
Specialty Type
Internal Medicine
Map
Address