Unal    Tutak    MD
Contract Details
Pain Management Services
Facility name
Provider ID
P000001772
NPI
1073599023
Tax ID
721378440
Effective Date
6/15/1999
Last Updated
12/12/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
513 Brookwood Boulevard Suite 101
Birmingham, AL 35209
United States
County
Jefferson
Phone
2058026565 (Phone)
Billing Details
Address
513 Brookwood Boulevard
Suite 101
Birmingham, AL 35209
Billing Phone
2058026565
Specialty Type
Pain Management
Map
Address