Gilbert    Douglas    MD
Contract Details
Norwood Clinic
Facility name
Provider ID
P000008616
NPI
1881865103
Tax ID
630715625
Effective Date
1/1/2017
Last Updated
3/30/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
313 Fieldstown Road Suite 103
Gardendale, AL 35071
United States
County
Jefferson
Phone
2056310055 (Phone)
Billing Details
Address
P.O. Box 830230
Birmingham, AL 35283
Billing Phone
8002726481
Specialty Type
Family Practice
Map
Address