Bendt  P  Petersen  III  MD
Contract Details
The Orthopaedic Group, P.C.
Facility name
Provider ID
P000001350
NPI
1477510915
Tax ID
631187140
Effective Date
6/15/1999
Last Updated
7/23/2020
Direct Contract
Yes
Term Date
7/21/2020
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
1720 Springhill Avenue Suite 100
Mobile, AL 36604
United States
County
Mobile
Phone
2514765050 (Phone)
Billing Details
Address
1720 Springhill Avenue
Suite 100
Mobile, AL 36604
Billing Phone
2514765050
Specialty Type
Surgery, Orthopedic Spine
Map
Address