# 4MD2 IN PATIENT PHYSICIAN SERVICES OF DECATUR LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134273345
- **Authorized official:** MR. GUY DUWANE HOOPER (PRESIDENT)
- **Authorized official phone:** (205) 999-6209

## Contact information

- **Practice address:** 1201 7TH ST SE, DECATUR, AL 35601-3337
- **Practice address phone:** (256) 341-2909
- **Practice address fax:** (256) 301-0053
- **Mailing address:** 1028 HIGHLAND LAKES TRCE, BIRMINGHAM, AL 35242-6877
- **Mailing address phone:** (205) 999-6209
- **Mailing address fax:** (205) 408-1719

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171W00000X | Contractor | — | — | Yes |

## Other

- **Enumeration date:** 01/23/2007
- **Last updated:** 08/22/2020