Whitney    Dyer    NP
Contract Details
Addison Medical Clinic
Facility name
Provider ID
P000000001
NPI
1083374037
Tax ID
274188155
Effective Date
6/7/2023
Last Updated
6/15/2023
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
16356 County Road 41
Addison, AL 35540
United States
Phone
256-747-1186 (Phone)
Billing Details
Address
16356 County Road 41
Addison, AL 35540
Billing Phone
256-747-1186
Specialty Type
Nurse Practitioner
Map
Address