Terry  W  Taylor    MD
Contract Details
Occupational Health Clinic
Facility name
Provider ID
P000001716
NPI
1245381409
Tax ID
463558386
Effective Date
10/1/2013
Last Updated
3/7/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
89.00
Location Details
Address
5912 Old Mobile Avenue Suite 1
Pascagoula, MS 39581
United States
County
Jackson
Phone
2287624642 (Phone)
Billing Details
Address
2050 Michigan Avenue
Mobile, AL 36615
Billing Phone
2514346770
Specialty Type
Occupational Medicine
Map
Address