Provider Demographics
NPI:1073694659
Name:GASTROENTEROLOGISTS PC
Entity Type:Organization
Organization Name:GASTROENTEROLOGISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:M
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-970-1954
Mailing Address - Street 1:1625 N ALSTON ST
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-2208
Mailing Address - Country:US
Mailing Address - Phone:251-970-1954
Mailing Address - Fax:251-970-1960
Practice Address - Street 1:1625 N ALSTON ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-2208
Practice Address - Country:US
Practice Address - Phone:251-970-1954
Practice Address - Fax:251-970-1960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00012151207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALJ278Medicare ID - Type UnspecifiedSATELLITE OFFICE GROUP #
ALG828Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER