Jeffrey    Black    MD
Contract Details
Southlake Orthopaedics
Facility name
Provider ID
P000000001
NPI
1336646629
Tax ID
922164113
Effective Date
1/1/2024
Last Updated
9/18/2024
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
4517 Southlake Parkway
Hoover, AL 35244
United States
Phone
205-985-4326 (Phone)
Billing Details
Address
4517 Southlake Parkway
Hoover, AL 35244
Billing Phone
205-985-4326
Specialty Type
Radiology, Diagnostic
Map
Address