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Mark
A
Roberts
MD
Contract Details
Mark A. Roberts, M.D., P.C.
Facility name
Provider ID
P000008315
NPI
1275565442
Tax ID
205693770
Effective Date
7/15/2015
Last Updated
9/21/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
106 Edwina Street
Evergreen, AL 36401
United States
County
Conecuh
Phone
2515784300
(
Phone
)
Billing Details
Address
106 Edwina Street
Evergreen, AL 36401
Billing Phone
2515784300
Specialty Type
Family Practice
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Address