Provider Demographics
NPI:1750693537
Name:GASTROINTESTINAL ASSOCIATES WEST
Entity type:Organization
Organization Name:GASTROINTESTINAL ASSOCIATES WEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BERGEIN
Authorized Official - Middle Name:F
Authorized Official - Last Name:OVERHOLT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-588-5121
Mailing Address - Street 1:11440 PARKSIDE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-2658
Mailing Address - Country:US
Mailing Address - Phone:865-588-5121
Mailing Address - Fax:865-588-2126
Practice Address - Street 1:801 N WEISGARBER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2706
Practice Address - Country:US
Practice Address - Phone:865-588-5121
Practice Address - Fax:865-588-2126
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GASTROINTESTINAL ASSOCIATES PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty