Healthcare Provider Details

I. General information

NPI: 1962870477
Provider Name (Legal Business Name): CENTRAL ALABAMA MEDICAL CONTRACTORS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2015
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 KELLEY BLVD STE D
MILLBROOK AL
36054-2221
US

IV. Provider business mailing address

101 KELLEY BLVD STE D
MILLBROOK AL
36054-2221
US

V. Phone/Fax

Practice location:
  • Phone: 334-245-2600
  • Fax: 334-245-2610
Mailing address:
  • Phone: 334-245-2600
  • Fax: 334-245-2610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES DENNIS WOOLDRIDGE
Title or Position: CO-OWNER
Credential: MD
Phone: 334-300-4460