Provider Demographics
NPI:1780695999
Name:GASTROINTESTINAL ASSOCIATES, PC
Entity type:Organization
Organization Name:GASTROINTESTINAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:F
Authorized Official - Last Name:DEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-558-0644
Mailing Address - Street 1:POST OFFICE BOX 59002
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37950
Mailing Address - Country:US
Mailing Address - Phone:865-588-5121
Mailing Address - Fax:865-588-2126
Practice Address - Street 1:1311 DOWELL SPRINGS BOULEVARD
Practice Address - Street 2:SUITE 300
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909
Practice Address - Country:US
Practice Address - Phone:865-588-5121
Practice Address - Fax:865-588-4196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3705184Medicaid
TN3705184Medicaid
TN3705184Medicare PIN