Provider Demographics
NPI:1023450517
Name:PINNACLE COLON AND RECTAL SURGEONS, PLLC
Entity type:Organization
Organization Name:PINNACLE COLON AND RECTAL SURGEONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:GILPIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:602-714-6745
Mailing Address - Street 1:1300 N 12TH ST
Mailing Address - Street 2:SUITE 619
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2848
Mailing Address - Country:US
Mailing Address - Phone:602-714-5482
Mailing Address - Fax:602-714-6745
Practice Address - Street 1:1300 N 12TH ST
Practice Address - Street 2:SUITE 619
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2848
Practice Address - Country:US
Practice Address - Phone:602-714-5482
Practice Address - Fax:602-714-6745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty