Provider Demographics
NPI:1982626693
Name:ASSOCIATED GASTROENTEROLOGISTS, LTD.
Entity Type:Organization
Organization Name:ASSOCIATED GASTROENTEROLOGISTS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:GULINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-279-2064
Mailing Address - Street 1:9327 N 3RD ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2470
Mailing Address - Country:US
Mailing Address - Phone:602-279-2064
Mailing Address - Fax:
Practice Address - Street 1:9327 N 3RD STREET
Practice Address - Street 2:SUITE 306
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020
Practice Address - Country:US
Practice Address - Phone:602-279-3575
Practice Address - Fax:602-279-2666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZWCKHWMedicare ID - Type Unspecified