Contract Details
Facility name
University Family Practice
Provider ID
P000007468
NPI
1225137763
Tax ID
721396366
Effective Date
12/15/1999
Last Updated
9/12/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
904 Anna Avenue
Tuscaloosa, AL 35401
United States
County
Tuscaloosa
Phone
2053456960 (Phone)
Billing Details
Address
904 Anna Avenue
Tuscaloosa, AL 35401
Billing Phone
2053456960
Specialty Type
Family Practice
Map
Address