Contract Details
Infirmary Medical Clinics
Facility name
IMC Diagnostic and Medical Clinic Daphne
Provider ID
P000008971
NPI
1235659319
Tax ID
631012832
Effective Date
10/30/1992
Last Updated
11/7/2022
Direct Contract
Yes
Term Date
10/6/2022
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
27961 Highway 98 Suite 14
Daphne, AL 36526
United States
County
Baldwin
Phone
2516261175 (Phone)
Billing Details
Address
27961 Highway 98
Suite 14
Daphne, AL 36526
Billing Phone
2516261175
Specialty Type
Internal Medicine
Map
Address