Contract Details
Facility name
Brookwood Primary Care - Vestavia
Provider ID
P000002600
NPI
1225348527
Tax ID
630574010
Effective Date
4/24/2002
Last Updated
5/21/2017
Direct Contract
Yes
Term Date
3/17/2014
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_058
Location Details
Address
2017 Canyon Road Suite 39
Birmingham, AL 35216
United States
County
Jefferson
Phone
2058717746 (Phone)
Billing Details
Address
2017 Canyon Road
Suite 39
Birmingham, AL 35216
Billing Phone
2058717746
Specialty Type
Family Practice
Map
Address