Healthcare Provider Details

I. General information

NPI: 1366442873
Provider Name (Legal Business Name): DEBBIE WYVETTE REDMOND-HYDER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 PROVIDENCE MAIN ST NW STE 202
HUNTSVILLE AL
35806-4815
US

IV. Provider business mailing address

475 PROVIDENCE MAIN ST NW STE 202
HUNTSVILLE AL
35806-4815
US

V. Phone/Fax

Practice location:
  • Phone: 256-830-9600
  • Fax: 256-830-9588
Mailing address:
  • Phone: 256-830-9600
  • Fax: 256-830-9588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberD0353
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: