Patrick  D  Grant    MD
Contract Details
MRI of Clanton
Facility name
Provider ID
P000007674
NPI
1811102734
Tax ID
630587021
Effective Date
11/5/2013
Last Updated
5/10/2017
Direct Contract
Yes
Term Date
10/1/2016
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1011 Lay Dam Road
Clanton, AL 35045
United States
County
Chilton
Phone
2052805622 (Phone)
Billing Details
Address
P.O. Box 2514
Birmingham, AL 35201
Billing Phone
2058714274
Specialty Type
Radiology, Diagnostic
Map
Address