Kristina  J  Donovan    DO
Contract Details
Sportsmed Orthopaedic Surgery & Spine Center
Facility name
Provider ID
P000003566
Tax ID
631262177
Effective Date
9/1/2012
Last Updated
6/9/2016
Direct Contract
Yes
Term Date
6/12/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
4715 Whitesburg Drive
Huntsville, AL 35802
United States
County
Madison
Phone
2568815151 (Phone)
Billing Details
Address
4715 Whitesburg Drive
Huntsville, AL 35802
Billing Phone
2568815151
Specialty Type
Pain Medicine
Map
Address