Organization
4MD2 IN PATIENT PHYSICIAN SERVICES OF DECATUR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GUY DUWANE HOOPER (PRESIDENT)
(205) 999-6209
Entity
Organization
Contact information
Practice address
1201 7TH ST SE, DECATUR, AL 35601-3337
(256) 341-2909
(256) 301-0053
Mailing address
1028 HIGHLAND LAKES TRCE, BIRMINGHAM, AL 35242-6877
(205) 999-6209
(205) 408-1719
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
01/23/2007
Last updated
08/22/2020
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