Matthew    Jackson    DO
Contract Details
OrthoSports Associates
Facility name
Provider ID
P000000001
NPI
1114226438
Tax ID
275501752
Effective Date
12/13/2022
Last Updated
1/4/2024
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_508
Location Details
Address
7191 Cahaba Valley Road Suite 200A
Hoover, AL 35242
United States
Phone
205-939-0447 (Phone)
Billing Details
Address
P.O. Box 1144
Franklin, TN 37065
Billing Phone
205-939-0447
Specialty Type
Surgery, Orthopedic
Map
Address