David  W  Purner    MD
Contract Details
Medical East
Facility name
Provider ID
P000003501
NPI
1083623987
Tax ID
636002175
Effective Date
10/5/2000
Last Updated
7/16/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
15243 Greenfield Drive
Athens, AL 35613
United States
County
Limestone
Phone
2567710994 (Phone)
Billing Details
Address
15243 Greenfield Drive
Athens, AL 35613
Billing Phone
2567710994
Specialty Type
Urgent Care
Map
Address