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Edgar
L
Ready
IV
MD
Contract Details
Retina Specialists of North Alabama
Facility name
Provider ID
P000007349
NPI
1932136355
Tax ID
631248340
Effective Date
10/1/2002
Last Updated
5/5/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
1436 Gunter Avenue
Guntersville, AL 35976
United States
County
Marshall
Phone
2565056916
(
Phone
)
Billing Details
Address
P.O. Box 830529
Birmingham, AL 35283
Billing Phone
2565398851
Specialty Type
Ophthalmology
Map
Address