Individual
DR. CHRISTOPHER CENTAFONT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1150 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 712-1929
(334) 712-2799
Mailing address
1150 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 712-1929
(334) 712-2799
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
378-DO
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000055301
—
AL
05
—
000095006
—
AL
05
—
00599266A
—
GA
01
—
051024479
BLUE CROSS
AL
01
—
051055301
BLUE CROSS
AL
01
—
051095006
BLUE CROSS
AL
01
—
051540467
BLUE CROSS
AL
05
—
375117100
—
FL
05
—
375117101
—
FL
01
—
61819
BLUE CROSS
FL
01
—
631087996
TAX ID#
—
Enumeration date
01/16/2006
Last updated
02/03/2011
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