Provider Demographics
NPI:1306266366
Name:DECATUR MORGAN INFECTIOUS DISEASES & TRAVEL MEDICINE
Entity type:Organization
Organization Name:DECATUR MORGAN INFECTIOUS DISEASES & TRAVEL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, EMPLOYED PHYSICIAN NETWORK
Authorized Official - Prefix:MS
Authorized Official - First Name:DARCELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:256-341-2802
Mailing Address - Street 1:1215 7TH ST SE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3337
Mailing Address - Country:US
Mailing Address - Phone:256-350-1862
Mailing Address - Fax:256-350-9812
Practice Address - Street 1:1215 7TH ST SE
Practice Address - Street 2:SUITE 120
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3337
Practice Address - Country:US
Practice Address - Phone:256-350-1862
Practice Address - Fax:256-350-9812
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DECATUR MORGAN HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty