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Organization
DCH PROVIDER SERVICES, LLC
Active
Organization
DCH PROVIDER SERVICES, LLC
Active
Other names
Fayette Medical Center Hospitalists
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL CLAY CONVILLE (DIRECTOR, PHYSICIAN SERVICES)
(205) 759-6165
Entity
Organization
Contact information
Practice address
1653 TEMPLE AVE N, FAYETTE, AL 35555-1314
(205) 932-1280
(205) 932-1260
Mailing address
1110 DR EDWARD HILLARD DR STE A, TUSCALOOSA, AL 35401-7446
(205) 333-4661
(205) 333-4660
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113147
—
AL
01
—
1841421757
GROUP NPI
AL
01
—
DA1832
MEDICARE RAILROAD
—
Enumeration date
07/28/2009
Last updated
01/13/2021
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