Gordon    Spafford    MD
Contract Details
Infirmary Medical Clinics
Facility name
Provider ID
P000001650
NPI
1326096173
Tax ID
631012832
Effective Date
10/7/2022
Last Updated
10/31/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1908 Hand Avenue
Bay Minette, AL 36507
United States
County
Baldwin
Phone
2514351200 (Phone)
Billing Details
Address
1908 Hand Avenue
Bay Minette, AL 36507
Billing Phone
2514351200
Specialty Type
Family Practice
Map
Address