James    Loren    MD
Contract Details
Affinity Orthopedic Specialists
Facility name
Provider ID
P000009458
NPI
1386807626
Tax ID
364907908
Effective Date
4/18/2019
Last Updated
12/5/2019
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
5018 Cahaba River Road
Vestavia, AL 35243
United States
County
Jefferson
Phone
2053975200 (Phone)
Billing Details
Address
P.O. Box 54568
Belfast, ME 04915
Billing Phone
2059713610
Specialty Type
Surgery, Orthopedic
Map
Address