Daniel    Avery  III  MD
Contract Details
OrthoSports Associates, LLC
Facility name
Provider ID
P000000001
NPI
1235440918
Tax ID
275501752
Effective Date
5/1/2023
Last Updated
4/5/2023
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_508
Location Details
Address
1021 Montgomery Hwy Suite 203
Vestavia Hills, AL 35216
United States
Phone
205-781-1950 (Phone)
Billing Details
Address
P.O. Box 1144
Franklin, TN 37065
Billing Phone
205-781-1950
Specialty Type
Surgery, Orthopedic
Map
Address