Jonathan  R  Moore  Sr  MD
Contract Details
American Family Care--Birmingham-Homewood
Facility name
Provider ID
P000001191
NPI
1598841322
Tax ID
630825248
Effective Date
7/1/2011
Last Updated
4/24/2018
Direct Contract
Yes
Term Date
4/24/2018
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2757 Greensprings Highway
Birmingham, AL 35209
United States
County
Jefferson
Phone
2052900088 (Phone)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
2054038902
Specialty Type
General Practice
Map
Address