Edwin  R  Gray    MD
Contract Details
American Family Care--Huntsville-Whitesburg Drive
Facility name
Provider ID
P000003491
NPI
1629033568
Tax ID
630825248
Effective Date
7/1/2011
Last Updated
4/24/2018
Direct Contract
Yes
Term Date
4/24/2018
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
8151 Whitesburg Drive
Huntsville, AL 35802
United States
County
Madison
Phone
2568829711 (Phone)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
2054038902
Specialty Type
Family Practice
Map
Address