Timothy  B  Decker    DO
Contract Details
DeKalb Regional Medical Center
Facility name
Provider ID
P000000412
NPI
1558322941
Tax ID
204370870
Effective Date
12/1/2008
Last Updated
6/13/2014
Direct Contract
Yes
Term Date
6/13/2014
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_011
Location Details
Address
511 Main Street Suite B
Rainsville, AL 35986
United States
County
De Kalb
Phone
2566381100 (Phone)
Billing Details
Address
P.O. Box 277507
Atlanta, GA 30384
Billing Phone
2569972317
Specialty Type
Family Practice
Map
Address