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DALE MEDICAL CENTER NPI 1497893408


NPI Information

NPI: 1497893408
Provider Name: DALE MEDICAL CENTER

Other Name: STATMED

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 01D0932199

Address:
1519 ANDREWS AVE
OZARK, AL
ZIP 36360
Phone: (334) 774-7610
Get Directions

DALE MEDICAL CENTER is a pediatrics in Ozark, AL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DALE MEDICAL CENTER NPI is 1497893408. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Statmed.

The provider's business location address is:

1519 ANDREWS AVE
OZARK, AL
ZIP 36360-719
Phone: (334) 774-7610
Fax: (334) 774-7251

The provider's authorized official is Vernon L. Johnson .
The authorized official title is Ceo and has the following contact phone number (334) 774-2601.

The CLIA number assigned to this NPI record is 01D0932199 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/2/2007 and was last updated on 4/11/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineNo
2207RP1001XInternal MedicinePulmonary DiseaseNo
3208000000XPediatricsYes
4363LF0000XNurse PractitionerFamilyNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1529908700MEDICAIDALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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