Jonathan  R  Moore  Sr  MD
Contract Details
Greystone Neurology & Pain Centers, Inc.
Facility name
Provider ID
P000001191
NPI
1598841322
Tax ID
810868581
Effective Date
1/1/2018
Last Updated
10/8/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_390
Location Details
Address
7500 Hugh Daniel Drive Suite 250
Birmingham, AL 35242
United States
County
Shelby
Phone
2059913300 (Phone)
Billing Details
Address
P.O. Box 382135
Birmingham, AL 35238
Billing Phone
2059913300
Specialty Type
General Practice
Map
Address