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Contract Details
Ortho Sports 1st
Facility name
Provider ID
P000000001
NPI
1417223892
Tax ID
844617903
Effective Date
7/31/2020
Last Updated
10/8/2020
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1031 Brocks Gap Parkway Suite 185
Hoover, AL 35244
United States
Phone
205-541-2252 (Phone)
Billing Details
Address
1031 Brocks Gap Parkway
Suite 185
Hoover, AL 35244
Billing Phone
205-541-2252
Specialty Type
Family Practice
Map
Address