MEDICARE: MRS. DEBORAH M HELMS PA-C

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	363AM0700X	Medical Physician Assistant	PA-204	AL

General Provider Information

NPI Number	:	1598733081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH M HELMS PA-C

Provider Business Mailing Address
First Line	:	7212 FORTNER ST
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36305-7325
Country	:	US
Telephone Number	:	334-793-4439
Fax Number	:	334-793-6759

Provider Business Practice Location Address
First Line	:	104 MEDICAL DR
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36303-6902
Country	:	US
Telephone Number	:	334-671-9445
Fax Number	:	334-836-0059

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	04/15/2010

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