Jian  H  Fong    MD
Contract Details
American Family Care--Birmingham-Hoover-The Grove
Facility name
Provider ID
P000007903
NPI
1760491419
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
5569 Grove Boulevard Suite 121
Birmingham, AL 35226
United States
County
Jefferson
Phone
2056372600 (Phone)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
2054038902
Specialty Type
Family Practice
Map
Address