Michael  D  Smith    MD
Contract Details
Outpatient Diagnostic Center of Madison
Facility name
Provider ID
P000006774
NPI
1306829155
Tax ID
631280228
Effective Date
12/6/2012
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_125
Location Details
Address
540 Hughes Road Suite 5
Madison, AL 35758
United States
County
Madison
Phone
2564618808 (Phone)
Billing Details
Address
P.O. Box 637237
Cincinnati, OH 45263
Billing Phone
8665915559
Specialty Type
Radiology, Diagnostic
Map
Address