Provider Demographics
NPI:1710051925
Name:GASTROENTEROLOGY ASSOCIATES, INC
Entity Type:Organization
Organization Name:GASTROENTEROLOGY ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LOURDES
Authorized Official - Middle Name:
Authorized Official - Last Name:WARFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-355-1144
Mailing Address - Street 1:1400 N RITTER AVE
Mailing Address - Street 2:SUITE 370
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-3052
Mailing Address - Country:US
Mailing Address - Phone:317-355-1144
Mailing Address - Fax:317-355-1155
Practice Address - Street 1:1400 N RITTER AVE
Practice Address - Street 2:SUITE 370
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-3052
Practice Address - Country:US
Practice Address - Phone:317-355-1144
Practice Address - Fax:317-355-1155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty