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
22423 Highway 72 East Suite A
Athens, AL 35613
United States
County
Limestone
Phone
2562309607 (Phone)
Billing Details
Address
4715 Whitesburg Drive
Huntsville, AL 35802
Billing Phone
2568815151
Specialty Type
Pain Management
Map
Address