Contract Details
Facility name
Mark A. Roberts, M.D., P.C.
Provider ID
P000008314
NPI
1952466211
Tax ID
205693770
Effective Date
7/15/2015
Last Updated
9/21/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
106 Edwina Street
Evergreen, AL 36401
United States
County
Conecuh
Phone
2515784300 (Phone)
Billing Details
Address
106 Edwina Street
Evergreen, AL 36401
Billing Phone
2515784300
Specialty Type
Family Practice
Map
Address