Gaynel    Taylor    MD
Contract Details
Southeast Alabama Medical Center Clinics
Facility name
Provider ID
P000007451
NPI
1033163183
Tax ID
636004476
Effective Date
7/1/1995
Last Updated
8/6/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
Houston Medical Group 1806 Fairview Avenue
Dothan, AL 36301
United States
County
Houston
Phone
3346775986 (Phone)
Billing Details
Address
1806 Fairview Avenue
Dothan, AL 36301
Billing Phone
3346775986
Specialty Type
Family Practice
Map
Address