Provider Demographics
NPI:1720595762
Name:MEDICAL ASSET GROUP, LLC
Entity Type:Organization
Organization Name:MEDICAL ASSET GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:J
Authorized Official - Last Name:UFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-907-9000
Mailing Address - Street 1:PO BOX 396
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35962-0396
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15239 AL HIGHWAY 68
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35962-3481
Practice Address - Country:US
Practice Address - Phone:256-925-0012
Practice Address - Fax:256-925-0016
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL ASSET GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty