Contract Details
Mizell Memorial Hospital
Facility name
Mizell Medical Clinic
Provider ID
P000000001
NPI
1760728455
Tax ID
630307951
Effective Date
1/1/2015
Last Updated
1/4/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
95.00
Location Details
Address
802 N Main Street
Opp, AL 36467
United States
Phone
334-493-3240 (Phone)
Billing Details
Address
P.O. Box 1010
Opp, AL 36467
Billing Phone
334-933-3541
Specialty Type
Family Practice
Website
Visit Website
Map
Address