MEDICARE: DECATUR GENERAL ONCOLOGY CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician

General Provider Information

NPI Number	:	1285684480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DECATUR GENERAL ONCOLOGY CENTER, LLC

Provider Business Mailing Address
First Line	:	PO BOX 2239
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35609-2239
Country	:	US
Telephone Number	:	256-341-2152
Fax Number	:

Provider Business Practice Location Address
First Line	:	1312 7TH ST SE
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35601-3340
Country	:	US
Telephone Number	:	256-355-0370
Fax Number	:	256-353-0891

Authorized Official
Title or Position	:	CEO
Name	:	MR. JAMES W HAHN
Credential	:
Telephone Number	:	256-341-2152

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	08/22/2020

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