Kevin    Michaels    MD
Contract Details
Alabama Providence Healthcare Services
Facility name
Provider ID
P000009098
NPI
1568430759
Tax ID
462847744
Effective Date
1/10/2018
Last Updated
3/21/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
5100 Rangeline Service Rd. N
Mobile, AL 36619
United States
County
Mobile
Phone
2513784000 (Phone)
Billing Details
Address
5100 Rangeline Service Rd. N
Mobile, AL 36619
Billing Phone
2513784000
Specialty Type
Occupational Medicine
Map
Address