Provider Demographics
NPI:1417993833
Name:GASTROENTEROLOGY CONSULTANTS OF
Entity type:Organization
Organization Name:GASTROENTEROLOGY CONSULTANTS OF
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-510-3324
Mailing Address - Street 1:202 DUKE OF GLOUCESTER ST SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-1372
Mailing Address - Country:US
Mailing Address - Phone:540-345-4900
Mailing Address - Fax:540-345-4179
Practice Address - Street 1:202 DUKE OF GLOUCHESTER ST
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014
Practice Address - Country:US
Practice Address - Phone:540-345-4900
Practice Address - Fax:540-345-4179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty