Provider Demographics
NPI:1932537750
Name:DIGESTIVE HEALTH ENDOSCOPY ASC LLC
Entity Type:Organization
Organization Name:DIGESTIVE HEALTH ENDOSCOPY ASC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:WHITFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-872-6291
Mailing Address - Street 1:90 INDUSTRIAL PARK CIR
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-5800
Mailing Address - Country:US
Mailing Address - Phone:228-872-6291
Mailing Address - Fax:
Practice Address - Street 1:90 INDUSTRIAL PARK CIR
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-5800
Practice Address - Country:US
Practice Address - Phone:228-872-6291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-15
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy