Juliet    Thornton    NP
Contract Details
Dr. Garry W Magouirk
Facility name
Provider ID
P000000001
NPI
1447864160
Tax ID
630936460
Effective Date
2/1/2022
Last Updated
2/3/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
110 23rd Street NW
Fayette, AL 35555
United States
Phone
205-932-3891 (Phone)
Billing Details
Address
110 23rd Street NW
Fayette, AL 35555
Billing Phone
205-932-3891
Specialty Type
Nurse Practitioner
Map
Address