Provider Demographics
NPI:1669889895
Name:DECATUR MORGAN PRIMARY CARE
Entity type:Organization
Organization Name:DECATUR MORGAN PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:S
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-973-2150
Mailing Address - Street 1:1215 7TH ST SE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3337
Mailing Address - Country:US
Mailing Address - Phone:256-351-5400
Mailing Address - Fax:256-351-5403
Practice Address - Street 1:1215 7TH ST SE
Practice Address - Street 2:SUITE 240
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3337
Practice Address - Country:US
Practice Address - Phone:256-351-5400
Practice Address - Fax:256-351-5403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty