John  O  Waits    MD
Contract Details
Surgical Specialists of Alabama
Facility name
Provider ID
P000006693
NPI
1396779161
Tax ID
721346438
Effective Date
10/24/2012
Last Updated
8/23/2017
Direct Contract
Yes
Term Date
8/15/2017
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
106.00
Fee Schedule Multiplier
Location Details
Address
1031 Fairfax Park
Tuscaloosa, AL 35406
United States
County
Tuscaloosa
Phone
2053452211 (Phone)
Billing Details
Address
1031 Fairfax Park
Tuscaloosa, AL 35406
Billing Phone
2053452211
Specialty Type
Surgery, General
Map
Address