Rick  A  Harrelson    MD
Contract Details
Elba Family Medicine
Facility name
Provider ID
P000007715
NPI
1578512083
Tax ID
271826294
Effective Date
4/20/2015
Last Updated
4/6/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
106.00
Fee Schedule Multiplier
Location Details
Address
918 Drayton Avenue
Elba, AL 36323
United States
County
Coffee
Phone
3348530191 (Phone)
Billing Details
Address
P.O. Box 9395
Belfast, ME 04915
Billing Phone
8778481463
Specialty Type
Internal Medicine
Map
Address