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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