Susan    Parker    CRNP
Contract Details
Henagar Family Medicine
Facility name
Provider ID
P000000001
NPI
1376508218
Tax ID
870720991
Effective Date
12/8/2021
Last Updated
12/15/2021
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
18324 Alabama Highway 75
Henagar, AL 35978
United States
Phone
256-657-1101 (Phone)
Billing Details
Address
18324 Alabama Highway 75
Henagar, AL 35978
Billing Phone
256-657-1101
Specialty Type
Family Practice
Website
Visit Website
Map
Address