Marty    McDonald    MD
Contract Details
Immediate Care of the South, LLC
Facility name
Provider ID
P000008584
NPI
1831122795
Tax ID
261882832
Effective Date
2/20/2017
Last Updated
2/20/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
4270 Cottage Hill Rd.
Mobile, AL 36609
United States
County
Mobile
Phone
2513002770 (Phone)
Billing Details
Address
P.O. Box 91687
Mobile, AL 36691
Billing Phone
2513002770
Specialty Type
Family Practice
Map
Address