Matthew    Smith    DO
Contract Details
Premier Orthopedic Surgery, Inc.
Facility name
Provider ID
P000008675
NPI
1336193440
Tax ID
204540503
Effective Date
4/6/2017
Last Updated
4/7/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
7938 AL Hwy 69 Ste. 100
Guntersville, AL 35976
United States
County
Marshall
Phone
2565718445 (Phone)
Billing Details
Address
7938 AL Hwy 69
Ste. 100
Guntersville, AL 35976
Billing Phone
2565718445
Specialty Type
Sports Medicine
Map
Address