Billy Wayne    McGough  Jr  MD
Contract Details
Andrews Sports Medicine & Orthopaedic Center
Facility name
Provider ID
P000002673
NPI
1982701462
Tax ID
475195311
Effective Date
3/4/2011
Last Updated
12/28/2021
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
805 St. Vincent's Drive Suite 100
Birmingham, AL 35205
United States
County
Jefferson
Phone
2059393699 (Phone)
Billing Details
Address
805 St. Vincent's Drive
Suite 100
Atlanta, GA 35205
Specialty Type
Sports Medicine
Map
Address