Individual
STACEY DAVIS TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
701 WILL HALSEY WAY, MADISON, AL 35758-2592
(256) 461-7440
(256) 461-7168
Mailing address
701 WILL HALSEY WAY, MADISON, AL 35758-2592
(256) 461-7440
(256) 461-7168
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD29320
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000118981
—
AL
05
—
630144587
—
AL
Enumeration date
06/07/2007
Last updated
02/08/2012
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