Gastrointestinal Associates, P.a. | |
1815 Mission 66 Vicksburg MS 39180-3709 | |
(601) 355-1234 | |
(601) 326-3566 |
Full Name | Gastrointestinal Associates, P.a. |
---|---|
Speciality | Internal Medicine - Gastroenterology |
Location | 1815 Mission 66, Vicksburg, Mississippi |
Authorized Official Name and Position | Pierce D Dotherow (AUTHORIZED OFFICIAL) |
Authorized Official Contact | 6013551234 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Gastrointestinal Associates, P.a. 2510 Lakeland Dr Flowood MS 39232-9513 Ph: (601) 355-1234 | Gastrointestinal Associates, P.a. 1815 Mission 66 Vicksburg MS 39180-3709 Ph: (601) 355-1234 |
NPI Number | 1144412438 |
---|---|
Provider Enumeration Date | 08/10/2007 |
Last Update Date | 12/06/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144412438 | NPI | - | NPPES |
09852713 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
2080P0206X | Pediatrics - Pediatric Gastroenterology | (* (Not Available)) | Secondary |
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