Daniel    Mince    MD
Contract Details
DeKalb RHC
Facility name
Provider ID
P000000001
NPI
1053172874
Tax ID
990697219
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
415 Medical Center Drive SW
Fort Payne, AL 35968
United States
Phone
833-255-8865 (Phone)
Billing Details
Address
415 Medical Center Drive SW
Fort Payne, AL 35968
Billing Phone
833-255-8865
Specialty Type
Internal Medicine
Map
Address