Charles    Gray    NP
Contract Details
Baileyton Family Medicine
Facility name
Provider ID
P000000001
NPI
1144801143
Tax ID
832826043
Effective Date
7/26/2022
Last Updated
7/28/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
105 Fire Station Road
Baileyton, AL 35019
United States
Phone
256-735-4057 (Phone)
Billing Details
Address
105 Fire Station Road
Baileyton, AL 35019
Billing Phone
256-735-4057
Specialty Type
Nurse Practitioner, Family
Website
Visit Website
Map
Address