Jeremiah    Maddox    MD
Contract Details
Southern Bone & Joint Specialists
Facility name
Provider ID
P000007411
NPI
1245449800
Tax ID
200870135
Effective Date
7/1/1998
Last Updated
8/28/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
345 Healthwest Drive
Dothan, AL 36301
United States
County
Houston
Phone
3347932663 (Phone)
Billing Details
Address
345 Healthwest Drive
Dothan, AL 36301
Billing Phone
3347932663
Specialty Type
Surgery, Orthopedic
Map
Address