Contract Details
Facility name
Southeastern Industrial and Family Medicine
Provider ID
P000007406
NPI
1427235381
Tax ID
943430149
Effective Date
6/1/2002
Last Updated
2/3/2016
Direct Contract
Yes
Term Date
12/31/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
2455 Bell Road
Montgomery, AL 36117
United States
County
Montgomery
Phone
3342614445 (Phone)
Billing Details
Address
2455 Bell Road
Montgomery, AL 36117
Billing Phone
3342614445
Specialty Type
Family Practice
Map
Address