Organization
MCMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW BRAGG CALDWELL MD (PHYSICIAN)
(256) 614-2444
Entity
Organization
Contact information
Practice address
22292 US HIGHWAY 72, ATHENS, AL 35613-2604
(256) 614-2444
Mailing address
22292 US HIGHWAY 72, ATHENS, AL 35613-2604
(256) 614-2444
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
32665
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32665
STATE LICENSE
AL
Enumeration date
12/12/2017
Last updated
03/16/2022
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