Provider Demographics
NPI:1154751345
Name:GERRISH GASTROENTEROLOGY, PL
Entity type:Organization
Organization Name:GERRISH GASTROENTEROLOGY, PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:GERRISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-304-2140
Mailing Address - Street 1:2102 S MACDILL AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-5934
Mailing Address - Country:US
Mailing Address - Phone:813-304-2140
Mailing Address - Fax:
Practice Address - Street 1:2102 S MACDILL AVE
Practice Address - Street 2:SUITE D
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5934
Practice Address - Country:US
Practice Address - Phone:813-304-2140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-25
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty