Shannon    Hilley    CRNP
Contract Details
DeKalb Orthopedics and Sports Medicine
Facility name
Provider ID
P000000001
NPI
1013411065
Tax ID
204370983
Effective Date
6/23/2020
Last Updated
6/26/2020
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
2506 Gault Avenue North Suite 200
Fort Payne, AL 35967
United States
Phone
256-979-1550 (Phone)
Billing Details
Address
2506 Gault Avenue North
Suite 200
Fort Payne, AL 35967
Billing Phone
256-979-1550
Specialty Type
Surgery, Orthopedic
Map
Address