Provider Demographics
NPI:1811138431
Name:PARKWAY MEDICAL CLINIC INC
Entity type:Organization
Organization Name:PARKWAY MEDICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CROWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-301-3414
Mailing Address - Street 1:1874 BELTLINE RD SW
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-5514
Mailing Address - Country:US
Mailing Address - Phone:256-350-2211
Mailing Address - Fax:256-301-3384
Practice Address - Street 1:1874 BELTLINE RD SW
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-5514
Practice Address - Country:US
Practice Address - Phone:256-350-2211
Practice Address - Fax:256-301-3384
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARKWAY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-11
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty