Ronald  C  McCoy  Sr  MD
Contract Details
American Family Care--Birmingham-Montclair Road
Facility name
Provider ID
P000003486
NPI
1184681793
Tax ID
630825248
Effective Date
7/1/2011
Last Updated
5/27/2014
Direct Contract
Yes
Term Date
5/27/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1652 Montclair Road
Birmingham, AL 35210
United States
County
Jefferson
Phone
2059569192 (Phone)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
2054038902
Specialty Type
Otolaryngology
Map
Address