Raymond    Ufford    MD
Contract Details
Facility name
Provider ID
P000000001
NPI
1679568752
Tax ID
823581568
Effective Date
7/21/2020
Last Updated
5/6/2021
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
15239 AL Highway 68
Crossville, AL 35962
United States
Phone
256-925-0012 (Phone)
Billing Details
Address
15239 AL Highway 68
Crossville, AL 35962
Billing Phone
256-925-0012
Specialty Type
Family Practice
Map
Address