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General NPI Number Information
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NPI Number | 1396790457
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Entity Type | Organization
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Legal Business Name | CHILDRENS MEDICAL CENTER OF DECATUR
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1874 BELTLINE RD SW
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City | DECATUR
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State | AL
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Zip | 35601-5514
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Country | US
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Telephone | 256-351-2273
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5809
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City | DECATUR
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State | AL
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Zip | 35601
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Country | US
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Telephone | 256-351-2273
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Fax | 256-351-2992
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Authorized Official
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Title or Position | OWNER
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Name | DR. ARLENE HAY
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Credential | M.D.
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Telephone | 256-351-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 00022572
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License Number State | AL
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