Blake    Bowden    MD
Contract Details
Gulf Orthopaedics
Facility name
Provider ID
P000000001
NPI
1073960704
Tax ID
922164113
Effective Date
6/1/2024
Last Updated
8/14/2024
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
75 Shell Street
Saraland, AL 36575
United States
Phone
251-435-2663 (Phone)
Billing Details
Address
75 Shell Street
Saraland, AL 36575
Billing Phone
251-435-2663
Specialty Type
Surgery, Orthopedic
Map
Address