Healthcare Provider Details
I. General information
NPI: 1790958072
Provider Name (Legal Business Name): DEBBIE REDMOND-HYDER, DO, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/08/2008
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
475 PROVIDENCE MAIN ST NW SUITE 202
HUNTSVILLE AL
35806-4815
US
IV. Provider business mailing address
475 PROVIDENCE MAIN ST NW SUITE 202
HUNTSVILLE AL
35806-4815
US
V. Phone/Fax
- Phone: 256-830-9600
- Fax: 256-830-9588
- Phone: 256-830-9600
- Fax: 256-830-9588
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DEBBIE
WYVETTE
REDMOND-HYDER
Title or Position: OWNER
Credential: D.O.
Phone: 256-830-9600