Connie    Chandler    MD
Contract Details
Ozark Medical Clinic
Facility name
Provider ID
P000009447
NPI
1215977129
Tax ID
636001875
Effective Date
12/23/2016
Last Updated
11/14/2019
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
145 Katherine Avenue
Ozark, AL 36360
United States
County
Dale
Phone
3347745100 (Phone)
Billing Details
Address
145 Katherine Avenue
Ozark, AL 36360
Billing Phone
3347745100
Specialty Type
Family Practice
Map
Address