Provider Demographics
NPI:1306280490
Name:DECATUR MORGAN WOMEN'S CENTER
Entity type:Organization
Organization Name:DECATUR MORGAN WOMEN'S CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISITNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-519-8282
Mailing Address - Street 1:1107 14TH AVE SE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3309
Mailing Address - Country:US
Mailing Address - Phone:256-351-7309
Mailing Address - Fax:256-351-7448
Practice Address - Street 1:1107 14TH AVE SE
Practice Address - Street 2:SUITE 320
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3309
Practice Address - Country:US
Practice Address - Phone:256-351-7309
Practice Address - Fax:256-351-7448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty