Provider Demographics
NPI:1932152410
Name:GASTROENTEROLOGY SPECIALISTS, INC.
Entity Type:Organization
Organization Name:GASTROENTEROLOGY SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATION OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-940-8500
Mailing Address - Street 1:10210 E 91ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5834
Mailing Address - Country:US
Mailing Address - Phone:918-940-8500
Mailing Address - Fax:918-940-8399
Practice Address - Street 1:10210 E 91ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5834
Practice Address - Country:US
Practice Address - Phone:918-940-8500
Practice Address - Fax:918-940-8399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100738590AMedicaid
OK=========Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER