Norman    Stevens    MD
Contract Details
Facility name
Provider ID
P000000001
NPI
1770583742
Tax ID
208057478
Effective Date
9/30/2020
Last Updated
10/8/2020
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_462
Location Details
Address
220 Hospital Drive
Jackson, AL 36545
United States
Phone
251-246-9021 (Phone)
Billing Details
Address
220 Hospital Drive
Jackson, AL 36545
Billing Phone
251-246-9021
Specialty Type
Family Practice
Map
Address