Tanyiska    Fonda    NP
Contract Details
OccMed Solutions, LLC
Facility name
Provider ID
P000009063
NPI
1528415478
Tax ID
264118930
Effective Date
1/22/2018
Last Updated
1/26/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
3144 Ross Clark Cr.
Dothan, AL 36303
United States
County
Houston
Phone
3346789123 (Phone)
Billing Details
Address
3144 Ross Clark Cr.
Dothan, AL 36303
Billing Phone
3346789123
Specialty Type
Occupational Medicine
Map
Address