Provider Demographics
NPI:1831303981
Name:DECATUR GENERAL HOSPITAL
Entity Type:Organization
Organization Name:DECATUR GENERAL HOSPITAL
Other - Org Name:JANICE NEAL, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-341-2000
Mailing Address - Street 1:1107 14TH AVE SE
Mailing Address - Street 2:SUITE G400
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3309
Mailing Address - Country:US
Mailing Address - Phone:256-309-5622
Mailing Address - Fax:256-309-5696
Practice Address - Street 1:1107 14TH AVE SE
Practice Address - Street 2:SUITE G400
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3309
Practice Address - Country:US
Practice Address - Phone:256-309-5622
Practice Address - Fax:256-309-5696
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DECATUR GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-09
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19301207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALF918OtherBCBS
ALF918OtherBCBS