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Benjamin
J
Schwartz
MD
Contract Details
Hughston Clinic--Dothan
Facility name
Provider ID
P000007239
NPI
1124230305
Tax ID
581155460
Effective Date
2/1/1994
Last Updated
12/2/2013
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
M
Exhibit ID
AM_140
AM_140
Location Details
Address
348 Healthwest Drive
Dothan, AL 36303
United States
County
Houston
Phone
3346995747
(
Phone
)
Billing Details
Address
P.O. Box 848249
Boston, MA 02284
Billing Phone
7063246661
Specialty Type
Surgery, Orthopedic
Map
Address