Amanda    Maddox    NP
Contract Details
Summerdale Family Medicine Clinic
Facility name
Summerdale Family Medicine Clinic
Provider ID
P000000001
NPI
1073109708
Tax ID
881467023
Effective Date
12/16/2022
Last Updated
1/13/2023
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
511 State Highway 59 N
Summerdale, AL 36580
United States
Phone
251-989-9400 (Phone)
Billing Details
Address
511 State Highway 59 N
Summerdale, AL 36580
Billing Phone
251-989-9400
Specialty Type
Nurse Practitioner
Website
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