Noel  M  Bergquist    MD
Contract Details
Open MRI of Jasper
Facility name
Provider ID
P000000125
NPI
1023040409
Tax ID
202513140
Effective Date
3/1/2006
Last Updated
6/24/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
301 North Walston Bridge Road Suite 104
Jasper, AL 35504
United States
County
Walker
Phone
2563870977 (Phone)
Billing Details
Address
301 North Walston Bridge Road
Suite 104
Jasper, AL 35504
Billing Phone
2563870977
Specialty Type
Radiology, Diagnostic
Map
Address