Stephen  T  Ikard    MD
Contract Details
University Orthopaedic Clinic & Spine Center
Facility name
Provider ID
P000000819
NPI
1144272642
Tax ID
630732734
Effective Date
5/4/2020
Last Updated
5/14/2020
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_452
Location Details
Address
2702 Hospital Drive Suite 101
Northport, AL 35476
United States
County
Tuscaloosa
Phone
2053450192 (Phone)
Billing Details
Address
2702 Hospital Drive
Suite 101
Northport, AL 35476
Billing Phone
2053450192
Specialty Type
Surgery, Orthopedic
Map
Address