Raymond  C  Ufford    MD
Contract Details
Medical Asset Group
Facility name
Provider ID
P000001773
NPI
1679568752
Tax ID
823581568
Effective Date
4/18/2023
Last Updated
4/19/2023
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
15239 Highway 68 West
Crossville, AL 35962
United States
County
De Kalb
Phone
256-907-9000 (Phone)
Billing Details
Address
15239 Highway 68 West
Crossville, AL 35962
Billing Phone
Specialty Type
Family Practice
Map
Address