Brian    King    DPM
Contract Details
Brian King DPM
Facility name
Provider ID
P000006086
Tax ID
363651907
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
96.00
Location Details
Address
1185 Dundee Ave Suite F
Elgin, IL 60120
United States
County
Kane
Phone
8476952661 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Podiatry
Map
Address