Ally    White    PA-C
Contract Details
Gulf Orthopaedics
Facility name
Provider ID
P000000001
NPI
1891471538
Tax ID
922164113
Effective Date
6/1/2024
Last Updated
10/17/2024
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
341 Greeno Road
Fairhope, AL 36532
United States
Phone
251-928-2401 (Phone)
Billing Details
Address
341 Greeno Road
Fairhope, AL 36532
Billing Phone
251-928-2401
Specialty Type
Physician Assistant
Map
Address