Provider Demographics
NPI:1194885699
Name:DECATUR OB GYN PHYSICIANS, PC
Entity type:Organization
Organization Name:DECATUR OB GYN PHYSICIANS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CMPE
Authorized Official - Phone:256-355-9216
Mailing Address - Street 1:1304 13TH AVE SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-4359
Mailing Address - Country:US
Mailing Address - Phone:256-355-9216
Mailing Address - Fax:256-351-6327
Practice Address - Street 1:1304 13TH AVE SE
Practice Address - Street 2:SUITE A
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4359
Practice Address - Country:US
Practice Address - Phone:256-355-9216
Practice Address - Fax:256-351-6327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL8779207V00000X
AL14320207V00000X
AL16383207V00000X
AL19601207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1043295181OtherNPI
AL1689659534OtherNPI
1194885699OtherGROUP NPI
AL1790760544OtherNPI
AL1700861713OtherNPI
AL1790760544OtherNPI
1194885699OtherGROUP NPI
ALE68758Medicare UPIN
ALG81766Medicare UPIN
ALC74972Medicare UPIN