Provider Demographics
NPI:1346496783
Name:ASSOCIATES IN GASTROENTEROLOGY, PLLC
Entity Type:Organization
Organization Name:ASSOCIATES IN GASTROENTEROLOGY, PLLC
Other - Org Name:VERMONT GASTROENTEROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-864-7483
Mailing Address - Street 1:875 ROOSEVELT HWY
Mailing Address - Street 2:SUITE 132
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-4460
Mailing Address - Country:US
Mailing Address - Phone:802-864-7483
Mailing Address - Fax:802-660-4337
Practice Address - Street 1:875 ROOSEVELT HWY
Practice Address - Street 2:SUITE 132
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-4460
Practice Address - Country:US
Practice Address - Phone:802-864-7483
Practice Address - Fax:802-660-4337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty