Provider Demographics
NPI:1619236064
Name:CALDWELL, MATTHEW BRAGG (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:BRAGG
Last Name:CALDWELL
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 1:22292 US HIGHWAY 72
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35613-2604
Mailing Address - Country:US
Mailing Address - Phone:256-614-2444
Mailing Address - Fax:
Practice Address - Street 1:22292 US HIGHWAY 72
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35613-2604
Practice Address - Country:US
Practice Address - Phone:256-614-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.32665207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine