Jesse  W  Austin  Jr  MD
Contract Details
All Med--Prattville
Facility name
Provider ID
P000007952
NPI
1346298171
Tax ID
200436418
Effective Date
4/18/1995
Last Updated
3/2/2016
Direct Contract
Yes
Term Date
3/2/2016
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
1840 East Main Street
Prattville, AL 36066
United States
County
Autauga
Phone
3343234000 (Phone)
Billing Details
Address
100 Capitol Commerce Boulevard
Suite 250
Montgomery, AL 36117
Billing Phone
3343234000
Specialty Type
Emergency Medicine
Map
Address