Travis  L  Thompson    MD
Contract Details
American Family Care--Montgomery-Eastchase
Facility name
Provider ID
P000003586
NPI
1831333830
Tax ID
630825248
Effective Date
7/1/2011
Last Updated
5/28/2014
Direct Contract
Yes
Term Date
5/28/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2570 Berryhill Road
Montgomery, AL 36117
United States
County
Montgomery
Phone
3343231330 (Phone)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
2054038902
Specialty Type
Family Practice
Map
Address