Richard    Wilson    MD
Contract Details
USA Health System
Facility name
Provider ID
P000007335
NPI
1134100589
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
1660 Springhill Avenue
Mobile, AL 36604
United States
County
Mobile
Phone
2516658000 (Phone)
Billing Details
Address
P.O. Box 40480
Mobile, AL 36604
Billing Phone
2516658000
Specialty Type
Radiology, Diagnostic
Map
Address