Provider Demographics
NPI:1508237124
Name:BINFORD, CHARLES ALFRED (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:ALFRED
Last Name:BINFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1381 WORTHINGTON DR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-6100
Mailing Address - Country:US
Mailing Address - Phone:386-860-2020
Mailing Address - Fax:
Practice Address - Street 1:1381 WORTHINGTON DR
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-6100
Practice Address - Country:US
Practice Address - Phone:386-860-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010262692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry