Michael  G  Martin    MD
Contract Details
OrthoSports Associates--Sylacauga
Facility name
Provider ID
P000001064
NPI
1588691224
Tax ID
275501752
Effective Date
5/16/2012
Last Updated
12/16/2013
Direct Contract
Yes
Term Date
12/16/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
209 West Spring Street Suite 301
Sylacauga, AL 35150
United States
County
Talladega
Phone
2052492249 (Phone)
Billing Details
Address
209 West Spring Street
Suite 301
Sylacauga, AL 35150
Billing Phone
2052492249
Specialty Type
Surgery, Orthopedic
Map
Address