Provider Demographics
NPI:1518356070
Name:DIGESTIVE DISEASE CENTER OF AMARILLO LLC
Entity Type:Organization
Organization Name:DIGESTIVE DISEASE CENTER OF AMARILLO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:R
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-345-6905
Mailing Address - Street 1:401 COMMERCE ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-2446
Mailing Address - Country:US
Mailing Address - Phone:615-345-6905
Mailing Address - Fax:
Practice Address - Street 1:6833 PLUM CREEK DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-1602
Practice Address - Country:US
Practice Address - Phone:806-467-9820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical