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Julian
O
Carlo
MD
Contract Details
Sherrill Orthopedics Sports and Hand Center
Facility name
Provider ID
P000008203
NPI
1598927881
Tax ID
474758186
Effective Date
3/16/2017
Last Updated
3/27/2017
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
200 Montgomery Highway Suite 125
Birmingham, AL 35216
United States
County
Jefferson
Phone
2058224357
(
Phone
)
Billing Details
Address
P.O. Box 742741
Atlanta, GA 30374
Billing Phone
2058224357
Specialty Type
Surgery, Orthopedic
Map
Address