John  R  Weaver    MD
Contract Details
Brookwood Sports and Orthopedics
Facility name
Provider ID
P000008202
NPI
1356370795
Tax ID
474758260
Effective Date
10/3/2015
Last Updated
5/16/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
200 Montgomery Highway Suite 200
Birmingham, AL 35216
United States
County
Jefferson
Phone
2058772663 (Phone)
Billing Details
Address
P.O. Box 742727
Atlanta, GA 30374
Billing Phone
2058772663
Specialty Type
Surgery, Orthopedic
Map
Address