Healthcare Provider Details

I. General information

NPI: 1811138431
Provider Name (Legal Business Name): PARKWAY MEDICAL CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2009
Last Update Date: 03/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1874 BELTLINE RD SW
DECATUR AL
35601-5514
US

IV. Provider business mailing address

1874 BELTLINE RD SW
DECATUR AL
35601-5514
US

V. Phone/Fax

Practice location:
  • Phone: 256-350-2211
  • Fax: 256-301-3384
Mailing address:
  • Phone: 256-350-2211
  • Fax: 256-301-3384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DANNY MICHAEL CROWE
Title or Position: CFO
Credential:
Phone: 256-301-3414