Steven  L  Mackey    MD
Contract Details
Russell Medical Center
Facility name
Provider ID
P000007366
NPI
1093725517
Tax ID
630385130
Effective Date
3/1/1999
Last Updated
6/10/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
125 Alison Drive Suite 8
Alexander City, AL 35010
United States
County
Tallapoosa
Phone
2564092159 (Phone)
Billing Details
Address
P.O. Box 939
Alexander City, AL 35011
Billing Phone
2563297109
Specialty Type
Dermatology
Map
Address