Tahir    Siddiq    MD
Contract Details
Perfect Kids and Family Care
Facility name
Provider ID
P000009075
NPI
1174631758
Tax ID
631070858
Effective Date
2/5/2018
Last Updated
2/15/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
308 Prairie Street N
Union Springs, AL 36089
United States
County
Bullock
Phone
3347381499 (Phone)
Billing Details
Address
308 Prairie Street N
Union Springs, AL 36089
Billing Phone
3347381499
Specialty Type
Internal Medicine
Map
Address