Healthcare Provider Details

I. General information

NPI: 1720595762
Provider Name (Legal Business Name): MEDICAL ASSET GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2017
Last Update Date: 12/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15239 AL HIGHWAY 68
CROSSVILLE AL
35962-3481
US

IV. Provider business mailing address

PO BOX 396
CROSSVILLE AL
35962-0396
US

V. Phone/Fax

Practice location:
  • Phone: 256-925-0012
  • Fax: 256-925-0016
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RAYMOND J UFFORD
Title or Position: OWNER, OFFICE MANAGER
Credential:
Phone: 256-907-9000