Charles  N  Ibie    MD
Contract Details
American Family Care--Orange Beach
Facility name
Provider ID
P000003542
NPI
1073742953
Tax ID
630825248
Effective Date
7/1/2011
Last Updated
5/27/2014
Direct Contract
Yes
Term Date
5/27/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
25775 Perdido Beach Boulevard Suite E-5
Orange Beach, AL 36561
United States
County
Baldwin
Phone
2519743004 (Phone)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
Specialty Type
Internal Medicine
Map
Address