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William
M
Meadows
Jr
MD
Contract Details
Surgical Clinic
Facility name
Provider ID
P000008015
NPI
1780614198
Tax ID
630653394
Effective Date
8/1/2014
Last Updated
9/9/2014
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
121 North 20th Street Building 3
Opelika, AL 36801
United States
County
Lee
Phone
3347456271
(
Phone
)
Billing Details
Address
121 North 20th Street
Building 3
Opelika, AL 36801
Billing Phone
3347456271
Specialty Type
Surgery, Plastic & Reconstructive
Map
Address