Kristina  J  Donovan    DO
Contract Details
SportsMed Orthopaedic Surgery & Spine Center
Facility name
Provider ID
P000007248
NPI
1780856013
Tax ID
631262177
Effective Date
1/1/2012
Last Updated
12/12/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_285
Location Details
Address
44 Hughes Road Suite 1100
Madison, AL 35758
United States
County
Madison
Phone
2564648200 (Phone)
Billing Details
Address
4715 Whitesburg Drive
Huntsville, AL 35802
Billing Phone
2568815151
Specialty Type
Pain Management
Map
Address