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Donald
E
Baker
MD
Contract Details
Southern Orthopedic and Sports Medicine Associates
Facility name
Provider ID
P000007295
NPI
1457513202
Tax ID
630889081
Effective Date
8/1/2013
Last Updated
8/27/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
2950 Highway 78 East
Jasper, AL 35501
United States
County
Walker
Phone
2052215374
(
Phone
)
Billing Details
Address
2950 Highway 78 East
Jasper, AL 35501
Billing Phone
2052215374
Specialty Type
Surgery, Orthopedic
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Address