Contract Details
Ancillary Care Services
Facility name
Diagnostic Ultrasound Consultants
Provider ID
P000006151
Tax ID
621072884
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
7460 Clarington Cove Suite A
Southaven, MS 38671
United States
County
DeSoto
Phone
6623493420 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address