Philemon  T  Spencer    MD
Contract Details
Tallassee Family Care
Facility name
Provider ID
P000007832
NPI
1437348950
Tax ID
630047680
Effective Date
3/6/2014
Last Updated
9/3/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
106.00
Fee Schedule Multiplier
Location Details
Address
115 Herren Hill Road
Tallassee, AL 36078
United States
County
Elmore
Phone
3342833477 (Phone)
Billing Details
Address
115 Herren Hill Road
Tallassee, AL 36078
Billing Phone
3342833477
Specialty Type
Family Practice
Map
Address