Alabama Developmental and Diagnostic Clinic LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

ALABAMA DEVELOPMENTAL AND DIAGNOSTIC CLINIC LLC

Practice address

105 Appleton LN
Madison, AL 35756-4162

Phone

(563) 424-0459

NPI assigned

Feb 1, 2023

Last updated

Feb 1, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Marc A Hultquist, DONPI 1063595593

Title

Owner

Phone

(563) 424-0459

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marc Alan Hultquist, D.O.

  • Pediatrics Physician
  • Madison, AL
  • NPI 1063595593
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675209600000",
    "number": "1346946308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 APPLETON LN",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357564162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 APPLETON LN",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357564162",
            "telephone_number": "563-424-0459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Johnson Rd SW",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358055847",
            "country_code": "US",
            "telephone_number": "256-650-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALABAMA DEVELOPMENTAL AND DIAGNOSTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A",
        "authorized_official_last_name": "HULTQUIST",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-424-0459",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Albert E. Willis, D.M.D., M.D., P.C.
• Melissa Kay Albright, CRNP
• Brandon James Alderton

• Medical Specialty Clinic/Center in Madison, AL
• Providers in Madison, AL by specialty
• Medical Specialty Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.