Andrew  G  Harrell    MD
Contract Details
Southeast Physician Network, PC
Facility name
Provider ID
P000006692
NPI
1992739882
Tax ID
270996600
Effective Date
8/16/2017
Last Updated
8/23/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
106.00
Fee Schedule Multiplier
Location Details
Address
1031 Fairfax Park
Tuscaloosa, AL 35406
United States
County
Tuscaloosa
Phone
2053452211 (Phone)
Billing Details
Address
P.O. Box 830525
Birmingham, AL 35283
Billing Phone
2053452211
Specialty Type
Surgery, General
Map
Address