Contract Details
Family Medical Clinic of Jackson, PC
Facility name
Family Medical Clinic of Jackson, PC
Provider ID
P000008478
NPI
1366808040
Tax ID
810977677
Effective Date
3/1/2016
Last Updated
9/14/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
227 Hospital Drive
Jackson, AL 36545
United States
County
Clarke
Phone
2512464446 (Phone)
Billing Details
Address
227 Hospital Drive
Jackson, AL 36545
Billing Phone
2512464446
Specialty Type
Family Practice
Map
Address