Charles  K  Funderburk    MD
Contract Details
Chilton Medical Associates
Facility name
Provider ID
P000008333
NPI
1447249750
Tax ID
631249784
Effective Date
10/21/2015
Last Updated
10/27/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
108 Medical Center Drive
Clanton, AL 35045
United States
County
Chilton
Phone
2057555700 (Phone)
Billing Details
Address
P.O. Box 1850
Clanton, AL 35046
Billing Phone
2057555700
Specialty Type
Family Practice
Map
Address