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James
Thomas
DPM
Contract Details
OrthoSports Associates
Facility name
Provider ID
P000000001
NPI
1740202191
Tax ID
275501752
Effective Date
12/13/2022
Last Updated
6/13/2023
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
M
Exhibit ID
AM_508
Exhibit Attachment
Location Details
Address
833 Saint Vincent's Drive Suite 403
Birmingham, AL 35205
United States
Phone
205-939-0447
(
Phone
)
Billing Details
Address
833 Saint Vincent's Drive
Suite 403
Birmingham, AL 35205
Billing Phone
205-939-0447
Specialty Type
Surgery, Orthopedic Foot & Ankle
Map
Address