Organization
DECATUR GENERAL HOSPITAL
Active
Other names
Tanya D DeLaVergne, MD
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEAN GRIFFIN (CEO)
(256) 341-2000
Entity
Organization
Contact information
Practice address
1215 7TH ST SE, SUITE 230, DECATUR, AL 35601-3337
(256) 350-4855
(256) 350-4866
Mailing address
PO BOX 2239, DECATUR, AL 35609-2239
(256) 350-4855
(256) 350-4866
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD29393
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118967
—
AL
Enumeration date
04/06/2012
Last updated
04/06/2012
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