Mary  E  Weaver    MD
Contract Details
AllSouth Urgent Care Clinic, Inc.
Facility name
Provider ID
P000008575
NPI
1588639264
Tax ID
263314700
Effective Date
1/30/2017
Last Updated
2/16/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1052 Ross Clark Circle
Dothan, AL 36303
United States
County
Houston
Phone
3346993600 (Phone)
Billing Details
Address
1052 Ross Clark Circle
Dothan, AL 36303
Billing Phone
3346993600
Specialty Type
Urgent Care
Map
Address