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NPI Code Detail

MEDICARE: RIVERSIDE PEDIATRICS OF DECATUR LLP

MEDICARE: RIVERSIDE PEDIATRICS OF DECATUR LLP
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
1364SF0001XFamily Health Clinical Nurse Specialist
2208000000XPediatrics Physician

General Provider Information

NPI Number : 1720448897
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVERSIDE PEDIATRICS OF DECATUR LLP
Provider Business Mailing Address
First Line : 1304 13TH AVE SE STE D
Second Line :
City : DECATUR
State : AL
Zip : 35601-4316
Country : US
Telephone Number : 256-355-1843
Fax Number : 256-340-2553
Provider Business Practice Location Address
First Line : 1304 13TH AVE SE STE D
Second Line :
City : DECATUR
State : AL
Zip : 35601-4316
Country : US
Telephone Number : 256-355-1843
Fax Number : 256-340-2553
Authorized Official
Title or Position : OWNER/PARTNER
Name : DAVID V PARMER
Credential : M.D.
Telephone Number : 256-355-1843
Provider Enumeration Date : 03/02/2016
Last Update Date : 03/02/2016

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Directions to “RIVERSIDE PEDIATRICS OF DECATUR LLP ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.