Roddie  R  Gantt    MD
Contract Details
Tennessee Valley Pain Consultants
Facility name
Provider ID
P000003562
Tax ID
631168726
Effective Date
1/1/2012
Last Updated
10/23/2017
Direct Contract
Yes
Term Date
12/31/2016
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
201 Governors Drive Suite 400
Huntsville, AL 35801
United States
County
Madison
Phone
2562657246 (Phone)
Billing Details
Address
101 Sivley Road Southwest
Huntsville, AL 35801
Billing Phone
2565337064
Specialty Type
Pain Medicine
Map
Address