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Contract Details
OrthoSports Athens, LLC
Facility name
OrthoSports Athens
Provider ID
P000008384
NPI
1659715803
Tax ID
452827135
Effective Date
2/17/2016
Last Updated
5/21/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1860 Highway 43
Winfield, AL 35594
United States
County
Fayette
Phone
2054871111
(
Phone
)
Billing Details
Address
1860 Highway 43
Winfield, AL 35594
Billing Phone
2054871111
Specialty Type
Surgery, Orthopedic
Map
Address