Tracy  L  Porter    NP
Contract Details
Metro Infectious Disease Consultants
Facility name
Provider ID
P000003523
NPI
1679713788
Tax ID
363966745
Effective Date
9/1/2017
Last Updated
8/11/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
107.00
Fee Schedule Multiplier
Location Details
Address
1102 Monroe Street Southwest
Huntsville, AL 35801
United States
County
Madison
Phone
2564697200 (Phone)
Billing Details
Address
901 McClintock Drive
Suite 202
Burr Ridge, IL 60527
Billing Phone
8882206432
Specialty Type
Nurse Practitioner
Map
Address