Vivian    Simmons    MD
Contract Details
Dr. Vivian Thomas Family Practice
Facility name
Provider ID
P000000001
NPI
1093989519
Tax ID
842292605
Effective Date
8/19/2020
Last Updated
8/31/2020
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
169 2nd Avenue
Hartford, AL 36344
United States
Phone
334-588-0804 (Phone)
Billing Details
Address
169 2nd Avenue
Hartford, AL 36344
Billing Phone
334-588-0804
Specialty Type
Family Practice
Map
Address