Lee  C  Whitaker    MD
Contract Details
American Family Care--Madison
Facility name
Provider ID
P000003507
NPI
1508809625
Tax ID
630825248
Effective Date
7/1/2011
Last Updated
5/28/2014
Direct Contract
Yes
Term Date
5/28/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
7559 Highway 72 West
Madison, AL 35758
United States
County
Madison
Phone
2565620850 (Phone)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
2054038902
Specialty Type
Family Practice
Map
Address