Allen    Goodson    MD
Contract Details
The Orthopaedic Center
Facility name
Provider ID
P000000634
NPI
1609837830
Tax ID
923966599
Effective Date
7/1/2023
Last Updated
1/31/2024
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_529
Location Details
Address
1797 Wilson Parkway
Fayetteville, TN 37334
United States
County
Lincoln
Phone
9314388168 (Phone)
Billing Details
Address
1797 Wilson Parkway
Huntsville, AL 37334
Billing Phone
2565392728
Specialty Type
Surgery, Orthopedic
Map
Address