Anthony    Sims    MD
Contract Details
DeKalb Primary Care
Facility name
Provider ID
P000000001
NPI
1992786636
Tax ID
990835906
Effective Date
12/19/2024
Last Updated
1/16/2025
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
18324 Broad Street
Henagar, AL 35978
United States
Phone
256-638-1181 (Phone)
Billing Details
Address
18324 Broad Street
Henagar, AL 35978
Billing Phone
256-638-1181
Specialty Type
Family Practice
Map
Address