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General NPI Number Information
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NPI Number | 1265996961
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Entity Type | Individual
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Provider Name | REBECCA DECKER DO
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Gender | Female
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Dates
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Enumeration Date | 01/27/2019
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 571 S FLOYD ST STE 342
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City | LOUISVILLE
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State | KY
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Zip | 40202-3816
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Country | US
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Telephone | 985-373-1408
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Fax |
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Provider Business Mailing Address
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Address Line | 7610 OLD SALEM RD
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City | LOUISVILLE
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State | KY
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Zip | 40242-4052
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Country | US
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Telephone | 985-373-1408
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 04543
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License Number State | KY
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