Theodore  M  Kopp    MD
Contract Details
Pinnacle Brain and Spine Center
Facility name
Provider ID
P000007497
NPI
1437348711
Tax ID
202719929
Effective Date
11/15/2007
Last Updated
9/23/2016
Direct Contract
Yes
Term Date
9/7/2016
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
6701 Airport Boulevard Suite D-146
Mobile, AL 36608
United States
County
Mobile
Phone
2516335155 (Phone)
Billing Details
Address
6701 Airport Boulevard
Suite D-146
Mobile, AL 36608
Billing Phone
2516335155
Specialty Type
Physical Medicine & Rehabilitation
Map
Address