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Individual

CHARLES DAVID WINFREY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
193 OATES DR, NEWTON, AL 36352-4312
(334) 299-3592
(334) 299-3870
Mailing address
1414 ELBA HWY, TROY, AL 36079-6020
(334) 670-6726
(334) 670-6731

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-59
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51532172
BCBS
AL
05
631804042
AL
Enumeration date
08/09/2006
Last updated
03/05/2013
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