Provider Demographics
NPI:1689448003
Name:KIDZGUT PLLC
Entity Type:Organization
Organization Name:KIDZGUT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BITAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-250-0580
Mailing Address - Street 1:PO BOX 12771
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85267-2771
Mailing Address - Country:US
Mailing Address - Phone:602-350-0435
Mailing Address - Fax:
Practice Address - Street 1:7010 E CHAUNCEY LN STE 210
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-3115
Practice Address - Country:US
Practice Address - Phone:602-350-0435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-07
Last Update Date:2023-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Multi-Specialty