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Cheryl
R
Goyne
MD
Contract Details
Southside Pain Specialists
Facility name
Provider ID
P000000639
NPI
1881702041
Tax ID
261605441
Effective Date
9/22/2016
Last Updated
6/15/2017
Direct Contract
Yes
Term Date
9/23/2016
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_326
AM_326
Location Details
Address
1020 26th Street South Suite 100
Birmingham, AL 35205
United States
County
Jefferson
Phone
2053323155
(
Phone
)
Billing Details
Address
1020 26th Street South
Suite 100
Birmingham, AL 35205
Billing Phone
2053323155
Specialty Type
Pain Medicine
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Address