Milton  A  Wallace  Jr  MD
Contract Details
The Orthopaedic Group, P.C.
Facility name
Provider ID
P000001814
NPI
1912964057
Tax ID
631187140
Effective Date
6/15/1999
Last Updated
2/16/2021
Direct Contract
Yes
Term Date
2/7/2021
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
2016 South Alabama Avenue
Monroeville, AL 36460
United States
County
Monroe
Phone
2514765050 (Phone)
Billing Details
Address
2016 South Alabama Avenue
Mobile, AL 36460
Billing Phone
2514765050
Specialty Type
Surgery, Orthopedic
Map
Address