Melvin  D  Russell    MD
Contract Details
Community Medical Arts Center
Facility name
Provider ID
P000007921
NPI
1760452999
Tax ID
630047680
Effective Date
3/6/2014
Last Updated
6/24/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
106.00
Fee Schedule Multiplier
Location Details
Address
875 Friendship Road
Tallassee, AL 36078
United States
County
Elmore
Phone
3342833111 (Phone)
Billing Details
Address
875 Friendship Road
Tallassee, AL 36078
Billing Phone
3342833111
Specialty Type
Family Practice
Map
Address