John  D  Blankenship    DO
Contract Details
American Family Care--Huntsville-University Drive
Facility name
Provider ID
P000003488
NPI
1013994342
Tax ID
630825248
Effective Date
7/1/2011
Last Updated
5/22/2014
Direct Contract
Yes
Term Date
5/22/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
4550 University Drive
Huntsville, AL 35816
United States
County
Madison
Phone
2567130560 (Phone)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
2054038902
Specialty Type
Family Practice
Map
Address