Julian  O  Carlo    MD
Contract Details
Brookwood Sports and Orthopedics
Facility name
Provider ID
P000008203
NPI
1598927881
Tax ID
474758260
Effective Date
11/2/2016
Last Updated
10/21/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
924 Fulton Avenue SW
Birmingham, AL 352111229
United States
County
Jefferson
Phone
2058772663 (Phone)
Billing Details
Address
P.O. Box 742727
Atlanta, GA 303742727
Billing Phone
2059404690
Specialty Type
Surgery, Orthopedic
Map
Address