Kennieth  C  McCollough  Jr  MD
Contract Details
North Alabama Bone & Joint Clinic
Facility name
Provider ID
P000007281
NPI
1720243421
Tax ID
630740487
Effective Date
7/1/1998
Last Updated
5/27/2015
Direct Contract
Yes
Term Date
5/27/2015
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
2129 Helton Drive
Florence, AL 35630
United States
County
Lauderdale
Phone
2567183200 (Phone)
Billing Details
Address
2129 Helton Drive
Florence, AL 35630
Billing Phone
2567183200
Specialty Type
Internal Medicine
Map
Address