Justin    Daigre    MD
Contract Details
Decatur Orthopaedic Clinic
Facility name
Provider ID
P000000001
NPI
1588737878
Tax ID
630799912
Effective Date
10/12/2021
Last Updated
10/29/2021
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_493
Location Details
Address
1103 16th Avenue Southeast
Decatur, AL 35601
United States
Phone
256-350-0362 (Phone)
Billing Details
Address
1103 16th Avenue Southeast
Decatur, AL 35601
Billing Phone
256-350-0362
Specialty Type
Surgery, Orthopedic
Website
Visit Website
Map
Address