Travis  L  Thompson    MD
Contract Details
American Family Care--Dothan
Facility name
Provider ID
P000003586
NPI
1831333830
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
2445 Murphy Mill Road
Dothan, AL 36303
United States
County
Houston
Phone
3346776001 (Phone)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
2054038902
Specialty Type
Family Practice
Map
Address