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John
A
Hamilton
MD
Contract Details
Infirmary Medical Clinics
Facility name
Provider ID
P000000699
NPI
1275684417
Tax ID
631056697
Effective Date
10/30/1992
Last Updated
10/28/2022
Direct Contract
Yes
Term Date
10/6/2022
Status
W9 Attachment
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
305 North Water Street
Mobile, AL 36602
United States
County
Mobile
Phone
2514333781
(
Phone
)
Billing Details
Address
305 North Water Street
Mobile, AL 36602
Billing Phone
2514333781
Specialty Type
Occupational Medicine
Map
Address