Breanne    Connors    CRNP
Contract Details
OrthoSports Associates
Facility name
Provider ID
P000009086
NPI
1093192981
Tax ID
275501752
Effective Date
12/13/2022
Last Updated
1/12/2023
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_508
Location Details
Address
2217 Decatur Highway
Gardendale, AL 35071
United States
County
Jefferson
Phone
2054181260 (Phone)
Billing Details
Address
2217 Decatur Highway
Birmingham, AL 35071
Billing Phone
2059390447
Specialty Type
Surgery, Orthopedic
Map
Address