James  V  Richardson    MD
Contract Details
American Family Care--Prattville
Facility name
Provider ID
P000003582
NPI
1114975125
Tax ID
630825248
Effective Date
7/1/2011
Last Updated
5/27/2014
Direct Contract
Yes
Term Date
5/27/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1965 Cobbs Ford Road
Prattville, AL 36066
United States
County
Autauga
Phone
3343617054 (Phone)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
2054038902
Specialty Type
General Practice
Map
Address