Gordon    Spafford    MD
Contract Details
Infirmary Medical Clinics
Facility name
Provider ID
P000001650
NPI
1326096173
Tax ID
631055669
Effective Date
10/30/1992
Last Updated
10/28/2022
Direct Contract
Yes
Term Date
10/6/2022
Status
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
Emergency Medicine
Map
Address