Weddington Bishop    Kelley    MD
Contract Details
Pulmonary Associates of the Southeast
Facility name
Provider ID
P000007502
NPI
1851314744
Tax ID
630854645
Effective Date
7/11/2013
Last Updated
9/19/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
880 Montclair Road Suite 270
Birmingham, AL 35213
United States
County
Jefferson
Phone
2058022000 (Phone)
Billing Details
Address
P.O. Box 131023
Birmingham, AL 35213
Billing Phone
2058022000
Specialty Type
Pulmonary Diseases
Map
Address