Russell    Goode    MD
Contract Details
Alabama Orthopaedic Clinic
Facility name
Provider ID
P000009411
NPI
1518278126
Tax ID
631174582
Effective Date
6/26/2018
Last Updated
8/4/2021
Direct Contract
Yes
Term Date
8/3/2021
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_388
Location Details
Address
3610 Springhill Memorial Drive North
Mobile, AL 36608
United States
County
Mobile
Phone
2514103600 (Phone)
Billing Details
Address
3610 Springhill Memorial Drive North
Mobile, AL 36608
Billing Phone
2514103600
Specialty Type
Surgery, Orthopedic
Map
Address