Brian    Anderson    PA-C
Contract Details
OrthoSports
Facility name
Provider ID
P000000001
NPI
1306079215
Tax ID
275501752
Effective Date
3/1/2024
Last Updated
2/28/2024
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_508
Location Details
Address
5850 Valley Road Suite 110
Birmingham, AL 35235
United States
Phone
205-838-3090 (Phone)
Billing Details
Address
5850 Valley Road
Suite 110
Birmingham, AL 35235
Billing Phone
205-838-3090
Specialty Type
Surgery, Orthopedic
Map
Address