Contract Details
Facility name
OrthoSports Associates - Talladega
Provider ID
P000007294
NPI
1588942767
Tax ID
275501752
Effective Date
5/16/2012
Last Updated
1/5/2023
Direct Contract
Yes
Term Date
12/12/2022
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
205 Medical Office Park
Talladega, AL 35160
United States
County
Talladega
Phone
2563621009 (Phone)
Billing Details
Address
205 Medical Office Park
Birmingham, AL 35160
Billing Phone
2059390447
Specialty Type
Surgery, Orthopedic
Map
Address