Provider Demographics
NPI:1477199347
Name:THERAPEUTIC GI ASSOCIATES, LLC
Entity Type:Organization
Organization Name:THERAPEUTIC GI ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:770-400-9186
Mailing Address - Street 1:PO BOX 98010
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30359-1710
Mailing Address - Country:US
Mailing Address - Phone:770-400-9186
Mailing Address - Fax:
Practice Address - Street 1:3925 PEACHTREE RD NE STE 200
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-2982
Practice Address - Country:US
Practice Address - Phone:770-400-9186
Practice Address - Fax:404-909-8665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-26
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty