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Contract Details
OccMed Solutions
Facility name
OccMed Solutions
Provider ID
P000009060
NPI
1093070187
Tax ID
264118930
Effective Date
1/22/2018
Last Updated
1/26/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
3144 Ross Clark Cr.
Dothan, AL 36303
United States
County
Houston
Phone
3346789123
(
Phone
)
Billing Details
Address
3144 Ross Clark Cr.
Dothan, AL 36303
Billing Phone
3346789123
Specialty Type
Family Practice
Map
Address