Monte    Ketchum    MD
Contract Details
Andrews Sports Medicine & Orthopaedic Center
Facility name
Provider ID
P000000001
NPI
1497133458
Tax ID
475195311
Effective Date
3/4/2011
Last Updated
12/28/2021
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1301 - A Bridge Creek Drive NE
Cullman, AL 35055
United States
Phone
205-939-3699 (Phone)
Billing Details
Address
1301 - A Bridge Creek Drive NE
Atlanta, GA 35055
Billing Phone
205-939-3699
Specialty Type
Surgery, Orthopedic
Map
Address