Kristy    Hooks    CRNP
Contract Details
Andalusia Orthopedics
Facility name
Provider ID
P000009277
NPI
1891945614
Tax ID
208016585
Effective Date
12/5/2018
Last Updated
12/19/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
95.00
Location Details
Address
301 Medical Avenue Suite C
Andalusia, AL 36420
United States
County
Covington
Phone
3342224442 (Phone)
Billing Details
Address
P.O. Box 1720
Andalusia, AL 36420
Billing Phone
3342224442
Specialty Type
Surgery, Orthopedic
Map
Address