Dennis    Doblar    PHD
Contract Details
Southern Pain Specialists
Facility name
Provider ID
P000003461
Tax ID
261605441
Effective Date
3/8/2012
Last Updated
8/26/2014
Direct Contract
Yes
Term Date
3/9/2012
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1528 Carraway Boulevard Suite 510
Birmingham, AL 35234
United States
County
Jefferson
Phone
2053323155 (Phone)
Billing Details
Address
1528 Carraway Boulevard
Suite 510
Birmingham, AL 35234
Billing Phone
2053323155
Specialty Type
Anesthesiology
Map
Address