Healthcare Provider Details

I. General information

NPI: 1043388374
Provider Name (Legal Business Name): DECATUR ORTHOPAEDICS SPECIALISTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 12/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3402 VESTAVIA CIR SW
DECATUR AL
35603-4604
US

IV. Provider business mailing address

PO BOX 5776
DECATUR AL
35601-0776
US

V. Phone/Fax

Practice location:
  • Phone: 256-318-8811
  • Fax: 256-350-3632
Mailing address:
  • Phone: 256-353-8811
  • Fax: 256-301-6196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number13433
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number13433
License Number StateAL

VIII. Authorized Official

Name: DR. JAY RICHARD SOLORIO
Title or Position: PRESIDENT OWNER
Credential: MD
Phone: 256-318-8811