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Andrew
G
Harrell
MD
Contract Details
Surgical Specialists of Alabama
Facility name
Provider ID
P000006692
NPI
1992739882
Tax ID
721346438
Effective Date
10/24/2012
Last Updated
8/23/2017
Direct Contract
Yes
Term Date
8/15/2017
Status
W9 Attachment
Contract Discounts
Discount Type
F
Fee Schedule Name
106.00
Fee Schedule Multiplier
Location Details
Address
1031 Fairfax Park
Tuscaloosa, AL 35405
United States
County
Tuscaloosa
Phone
2053452211
(
Phone
)
Billing Details
Address
1031 Fairfax Park
Tuscaloosa, AL 35405
Billing Phone
2053452211
Specialty Type
Surgery, General
Map
Address