Benjamin Banks    Fulmer    MD
Contract Details
Birmingham Neurosurgery & Spine Group--Pell City
Facility name
Provider ID
P000000587
NPI
1750331104
Tax ID
631034033
Effective Date
9/15/2007
Last Updated
5/13/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
7063 Veterans Parkway
Pell City, AL 35125
United States
County
Saint Clair
Phone
2059865200 (Phone)
Billing Details
Address
3125 Independence Drive
Suite 200
Birmingham, AL 35209
Billing Phone
2059865200
Specialty Type
Surgery, Neurological
Map
Address