Contract Details
Facility name
Family Practice Center
Provider ID
P000007220
NPI
1891846044
Tax ID
630848014
Effective Date
1/14/1993
Last Updated
11/11/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
217 Dothan Road
Abbeville, AL 36310
United States
County
Henry
Phone
3345856421 (Phone)
Billing Details
Address
217 Dothan Road
Abbeville, AL 36310
Billing Phone
3345856421
Specialty Type
Family Practice
Map
Address