Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center | |
Clinic/Center |
261Q00000X |
| NPI # | 1447231287 |
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| LBN Legal business name | GASTROENTEROLOGY SPECIALISTS INC | ||||||||||||||||||||
| Authorized official | ANA THEISEN - (PRACTICE ADMINISTRATOR) | ||||||||||||||||||||
| Entity | Organization | ||||||||||||||||||||
| Organization subpart 1 | No | ||||||||||||||||||||
| Enumeration date | 11/09/2005 | ||||||||||||||||||||
| Last updated | 01/14/2021 - About 5 years ago | ||||||||||||||||||||
| Identifiers |
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