John    Todd    MD
Contract Details
Facility name
Provider ID
P000000001
NPI
1528055142
Tax ID
631283588
Effective Date
7/28/2021
Last Updated
7/29/2021
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_489
Location Details
Address
1400 North McKenzie Street
Foley, AL 36535
United States
Phone
251-621-4700 (Phone)
Billing Details
Address
1400 North McKenzie Street
Foley, AL 36535
Billing Phone
251-621-4700
Specialty Type
Surgery, Orthopedic Shoulder
Website
Visit Website
Map
Address