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Contract Details
Southern Orthopaedic Alliance
Facility name
Gulf Orthopaedics
Provider ID
P000000001
Tax ID
922164113
Effective Date
6/1/2024
Last Updated
6/27/2024
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
5320 Highway 90 W
Mobile, AL 36619
United States
Phone
251-435-2663
(
Phone
)
Fax
251-435-1098
Billing Details
Address
5320 Highway 90 W
Mobile, AL 36619
Billing Phone
251-435-2663
Specialty Type
Surgery, Orthopedic
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