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Chad
E
Mathis
MD
Contract Details
OrthoSports Associates
Facility name
Provider ID
P000007513
NPI
1467444927
Tax ID
275501752
Effective Date
12/13/2022
Last Updated
1/12/2023
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
M
Exhibit ID
AM_508
Exhibit Attachment
Location Details
Address
2010 Patton Chapel Road Suite 100
Hoover, AL 35226
United States
County
Jefferson
Phone
2057835511
(
Phone
)
Billing Details
Address
2010 Patton Chapel Road
Suite 100
Birmingham, AL 35226
Billing Phone
2059390447
Specialty Type
Surgery, Orthopedic
Map
Address