GASTROINTESTINAL ASSOCIATES ENDOSCOPY CENTER, LLC; NPI #1366634669

Contact Information

GASTROINTESTINAL ASSOCIATES ENDOSCOPY CENTER, LLC

1815 MISSION 66
VICKSBURG, MS 39180-3709

Phone: 601-355-1234
Fax: 601-326-3566
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Endoscopy	261QE0800X

Indicates primary specialty

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NPI Profile & details for GASTROINTESTINAL ASSOCIATES ENDOSCOPY CENTER, LLC

NPI # 1366634669

LBN Legal business name GASTROINTESTINAL ASSOCIATES ENDOSCOPY CENTER, LLC

Authorized official PIERCE DOTHEROW - (AUTHORIZED OFFICIAL)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 08/10/2007

Last updated 12/06/2016 - About 10 years ago

Identifiers

MS	License #	25C0001065
MS	Medicaid	04837303

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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