Linda  K  Davenport    MD
Contract Details
American Family Care--Mobile-Tillman's Corner
Facility name
Provider ID
P000007814
NPI
1255315198
Tax ID
630825248
Effective Date
7/1/2011
Last Updated
4/24/2018
Direct Contract
Yes
Term Date
4/24/2018
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
5235 Rangeline Service Road South Suite 101
Mobile, AL 36619
United States
County
Mobile
Phone
2515446449 (Phone)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
2054038902
Specialty Type
Family Practice
Map
Address