Jodilyn    Jelsema    MD
Contract Details
Shoals Primary Care
Facility name
Provider ID
P000000001
NPI
1518195460
Tax ID
270952681
Effective Date
4/8/2021
Last Updated
4/16/2021
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
201 Rosa Lane
Florence, AL 35630
United States
Phone
2562753838 (Phone)
Billing Details
Address
201 Rosa Lane
Florence, AL 35630
Billing Phone
2562753838
Specialty Type
General Practice
Website
Visit Website
Map
Address