Provider Demographics
NPI:1093297517
Name:OAK STONE RURAL HEALTH CLINIC
Entity Type:Organization
Organization Name:OAK STONE RURAL HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:UFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-659-4321
Mailing Address - Street 1:PO BOX 403
Mailing Address - Street 2:
Mailing Address - City:GERALDINE
Mailing Address - State:AL
Mailing Address - Zip Code:35974-0403
Mailing Address - Country:US
Mailing Address - Phone:256-659-4321
Mailing Address - Fax:256-659-5968
Practice Address - Street 1:41718 AL HWY 75
Practice Address - Street 2:
Practice Address - City:GERALDINE
Practice Address - State:AL
Practice Address - Zip Code:35974-0403
Practice Address - Country:US
Practice Address - Phone:256-659-4321
Practice Address - Fax:256-659-5968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.8076207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID