Thomas    Leytham    MD
Contract Details
USA Health System
Facility name
Provider ID
P000007316
NPI
1629060785
Tax ID
630725648
Effective Date
9/25/2005
Last Updated
6/10/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
3301 Knollwood Drive
Mobile, AL 36693
United States
County
Mobile
Phone
2516605787 (Phone)
Billing Details
Address
P.O. Box 40480
Mobile, AL 36604
Billing Phone
2516605787
Specialty Type
Family Practice
Map
Address