Caleb    Yongkuma    MD
Contract Details
Vyas & Vyas
Facility name
Provider ID
P000007474
NPI
1417148081
Tax ID
630781454
Effective Date
10/30/1994
Last Updated
9/13/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
109 Medical Park Drive Suite B
Andalusia, AL 36420
United States
County
Covington
Phone
3342226041 (Phone)
Billing Details
Address
P.O. Box 1105
Andalusia, AL 36420
Billing Phone
3342226041
Specialty Type
Internal Medicine
Map
Address