Provider Demographics
NPI:1366659229
Name:JIMMEH, DECONTEE (MD)
Entity Type:Individual
Prefix:
First Name:DECONTEE
Middle Name:
Last Name:JIMMEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DECONTEE
Other - Middle Name:JIMMEH
Other - Last Name:FLETCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2270 VALLEYDALE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-2086
Mailing Address - Country:US
Mailing Address - Phone:205-982-3596
Mailing Address - Fax:205-982-4483
Practice Address - Street 1:2270 VALLEYDALE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-2086
Practice Address - Country:US
Practice Address - Phone:205-982-3596
Practice Address - Fax:205-982-4483
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL285512084N0400X
IA395882084N0400X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology