Provider Demographics
NPI:1902004971
Name:GASTROINTESTINAL AND LIVER CLINIC, PC
Entity Type:Organization
Organization Name:GASTROINTESTINAL AND LIVER CLINIC, PC
Other - Org Name:HORIZON GASTROENTEROLOGY & NEUROLOGY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:SOHAIL
Authorized Official - Last Name:SIDDIQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-840-1083
Mailing Address - Street 1:340 ATOKA MCLAUGHLIN DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:ATOKA
Mailing Address - State:TN
Mailing Address - Zip Code:38004-4824
Mailing Address - Country:US
Mailing Address - Phone:901-840-1083
Mailing Address - Fax:901-837-0183
Practice Address - Street 1:340 ATOKA MCLAUGHLIN DR
Practice Address - Street 2:SUITE C
Practice Address - City:ATOKA
Practice Address - State:TN
Practice Address - Zip Code:38004-4824
Practice Address - Country:US
Practice Address - Phone:901-840-1083
Practice Address - Fax:901-837-0183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty