Vincent    Law    MD
Contract Details
Russell Medical Center
Facility name
Provider ID
P000007371
NPI
1700952751
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
859 Airport Drive
Alexander City, AL 35010
United States
County
Tallapoosa
Phone
2562344295 (Phone)
Billing Details
Address
P.O. Box 939
Alexander City, AL 35011
Billing Phone
2563297109
Specialty Type
Family Practice
Map
Address