Debra  D  Banks    MD
Contract Details
American Family Care--Mobile-Montlimar Drive
Facility name
Provider ID
P000003509
NPI
1053475707
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
900 Montlimar Drive
Mobile, AL 36609
United States
County
Mobile
Phone
2513435263 (Phone)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
2054038902
Specialty Type
General Practice
Map
Address