DR. MIRANDA DECKER (NPI# 1699967612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699967612 |
| Entity Type | Individual |
| Full Name | DR. MIRANDA DECKER |
| Credential | MD |
| Practice Address |
535 Gandy St Ne Russellville AL 35653-1965 |
| Mailing Address |
Po Box 516 535 Gandy St Russellville AL 35653-0516 |
| Practice Telephone | 2563321120 |
| Practice Fax Number | 2563321198 |
| Mailing Telephone | 2563321120 |
| Mailing Fax Number | 2563321198 |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2007-10-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 28146 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BCBS | 510-06343 | 01 |
| Street Address |
535 GANDY ST NE |
| City | RUSSELLVILLE |
| State | AL |
| Zip Code | 35653-1965 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174715296 | Russellville Internal Medicine PC | Internal Medicine | 535 Gandy St Ne, Russellville, AL 35653-1965 | 2007-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902384720 | Randy Wade Gooch | Pharmacist | 13675 Us-43, Russellville, AL 35653 | 2018-08-02 |
| 1700301470 | Carole Ann Montgomery | Pharmacist | Walmart Pharmacy, 13675 Us-43, Russellville, AL 35653 | 2017-08-03 |
| 1548632755 | Amanda Carrie Franks | Health Educator | 265 Skyline Dr, Russellville, AL 35653 | 2015-10-27 |
| 1023411220 | Wesley Charles Mayfield | Pharmacist | 14001 Hwy 43 Suite 13, Russellville, AL 35653 | 2014-10-01 |
| 1831322841 | Family Health Care Clinic, Inc. | Clinic/Center | 318 Coffee Ave Ne, Russellville, AL 35653 | 2009-08-25 |
| 1538371075 | Eyedocs On Wheels PC | Optometrist | 15255 Hwy 43, Russellville, AL 35653 | 2007-05-04 |
| 1063634574 | Russellville Physician Practices LLC | Orthopaedic Surgery | 715 Gandy Street Ne, Suite B, Russellville, AL 35653 | 2007-05-03 |
| 1750404141 | Alabama Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 14695 Hwy 43, Russellville, AL 35653 | 2007-04-09 |
| 1629111703 | Franklin County Health Dept Offsite Epsdt | Public Health or Welfare | 801 Highway 48, Russellville, AL 35653 | 2007-02-15 |
| 1750457941 | Southern Rural Health Care Consortium, Inc. | Clinic/Center | 318 Coffee Avenue, Russellville, AL 35653 | 2006-11-28 |
| Find all providers in zip 35653 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174715296 | Russellville Internal Medicine PC | Internal Medicine | 535 Gandy St Ne, Russellville, AL 35653-1965 | 2007-08-13 |
| 1154332963 | Russellville Hospital, LLC | Internal Medicine | 531 Gandy St Ne, Russellville, AL 35653-1965 | 2006-08-10 |
| 1801840202 | Joseph A Zitterman Jr. | Internal Medicine | Freedom House, 400 Lake Front Drive, Russellville, AR 72802 | 2006-05-20 |
| 1437158243 | James Carlisle Dodson | Internal Medicine | 147 E 5th St, Russellville, KY 42276-1903 | 2005-07-14 |
| 1578176194 | Noydeen Medical Group- Russellville | Internal Medicine | 1605 W Main St, Russellville, AR 72801-2719 | 2020-08-24 |
| 1033671631 | Russellville Hospital Inc | Internal Medicine | 15225 Highway 43 Ste I, Russellville, AL 35653-1969 | 2019-04-02 |
| 1013408053 | Logan Physician Practice LLC | Internal Medicine | 975 Hopkinsville Rd, Russellville, KY 42276-9774 | 2018-05-25 |
| 1669861662 | Russellville Physicians LLC | Internal Medicine | 15225 Highway 43, Russellville, AL 35653-1999 | 2015-01-13 |
| 1174956841 | Russellville Physician Practices LLC | Internal Medicine | 15225 Highway 43, Suite G, Russellville, AL 35653-1999 | 2013-08-16 |
| 1629336078 | Jonathan David Brixey | Internal Medicine | 101 Skyline Dr, Russellville, AR 72801-3363 | 2012-04-23 |
| Find all providers in RUSSELLVILLE | ||||
| City | RUSSELLVILLE |
| Zip Code | 35653 |
Please comment or provide details below to improve the information on DR. MIRANDA DECKER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.