Jarod    Speer    MD
Contract Details
Childersburg Primary Care
Facility name
Provider ID
P000000001
NPI
1609947993
Tax ID
200356379
Effective Date
5/27/2020
Last Updated
6/3/2020
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
34011 Highway 280 East
Childersburg, AL 35044
United States
Phone
256-378-3313 (Phone)
Billing Details
Address
34011 Highway 280 East
Childersburg, AL 35044
Billing Phone
256-378-3313
Specialty Type
Family Practice
Map
Address