Gwen    Williams    MD
Contract Details
OrthoSports Associates--Birmingham-St. Vincent's East
Facility name
Provider ID
P000001872
NPI
1912975590
Tax ID
275501752
Effective Date
12/13/2022
Last Updated
1/12/2023
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_508
Location Details
Address
48 Medical Park Drive East Suite 255
Birmingham, AL 35235
United States
County
Jefferson
Phone
2058383090 (Phone)
Billing Details
Address
48 Medical Park Drive East
Suite 255
Birmingham, AL 35235
Billing Phone
2058383090
Specialty Type
Rheumatology
Map
Address