James  E  Stanford    DO
Contract Details
OrthoSports Athens, LLC
Facility name
Provider ID
P000008393
NPI
1447565775
Tax ID
472551706
Effective Date
2/17/2016
Last Updated
6/6/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1860 Highway 43
Winfield, AL 35594
United States
County
Fayette
Phone
2054871111 (Phone)
Billing Details
Address
1860 Highway 43
Winfield, AL 35594
Billing Phone
2054871111
Specialty Type
Surgery, Orthopedic
Map
Address