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Jeffrey
M
Saylor
MD
Contract Details
Lakeside Clinic North
Facility name
Provider ID
P000007268
NPI
1174589410
Tax ID
273149926
Effective Date
3/11/2013
Last Updated
5/21/2017
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
F
Fee Schedule Name
105.00
Fee Schedule Multiplier
Location Details
Address
7938 Highway 69 Suite 130
Guntersville, AL 35976
United States
County
Marshall
Phone
2565718460
(
Phone
)
Billing Details
Address
7938 Highway 69
Suite 130
Guntersville, AL 35976
Billing Phone
2565718460
Specialty Type
Family Practice
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Address