Organization
DECATUR INTERNAL MEDICINE CENTER, P.C.
Active
Organization
DECATUR INTERNAL MEDICINE CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIRK LEE JACKSON M.D. (PRESIDENT)
(256) 350-6363
Entity
Organization
Contact information
Practice address
2506 DANVILLE RD SW, SUITE 101, DECATUR, AL 35603-4232
(256) 350-6363
(256) 350-6855
Mailing address
PO BOX 870, CULLMAN, AL 35056-0870
(256) 775-0432
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG3025
RAILROAD MEDICARE
AL
Enumeration date
06/25/2006
Last updated
12/20/2007
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