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General NPI Number Information
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NPI Number | 1265663926
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Entity Type | Organization
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Legal Business Name | DCLH, INC.
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Dates
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Enumeration Date | 07/29/2009
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Last Update Date | 01/20/2010
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Provider Practice Location Address
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Address Line | 2908 CENTRAL AVE
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City | BIRMINGHAM
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State | AL
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Zip | 35209-2579
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Country | US
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Telephone | 205-871-7332
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Fax | 205-871-7336
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Provider Business Mailing Address
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Address Line | 2908 CENTRAL AVE
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City | BIRMINGHAM
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State | AL
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Zip | 35209-2579
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Country | US
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Telephone | 205-871-7332
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Fax | 205-871-7336
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. COREY L HARTMAN
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Credential | M.D.
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Telephone | 205-871-7332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD.025680
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License Number State | AL
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