Paul  F  Park    MD
Contract Details
American Family Care--Gardendale
Facility name
Provider ID
P000001315
NPI
1235186651
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
919 Odum Road
Gardendale, AL 35071
United States
County
Jefferson
Phone
2056316834 (Phone)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
2054038902
Specialty Type
Surgery, General
Map
Address