Member Login
Home
About Us
Become a Provider
Become a Member
Administrators
Contact Us
Member Login
Timothy
A
Cool
MD
Contract Details
OrthoSports Associates
Facility name
Provider ID
P000002639
NPI
1992765945
Tax ID
275501752
Effective Date
9/28/2011
Last Updated
6/7/2021
Direct Contract
Yes
Term Date
10/13/2015
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
52 Medical Park Drive East Suite 220
Birmingham, AL 35235
United States
County
Jefferson
Phone
2058384747
(
Phone
)
Billing Details
Address
52 Medical Park Drive East
Suite 220
Chicago, IL 35235
Billing Phone
2058384747
Specialty Type
Surgery, Orthopedic
Map
Address