Healthcare Provider Details

I. General information

NPI: 1194835124
Provider Name (Legal Business Name): GULF GASTROENTEROLOGY PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MEMORIAL HOSPITAL DR STE 305
MOBILE AL
36608-1786
US

IV. Provider business mailing address

101 MEMORIAL HOSPITAL DR 305
MOBILE AL
36608-1786
US

V. Phone/Fax

Practice location:
  • Phone: 251-380-7900
  • Fax: 251-281-1161
Mailing address:
  • Phone: 251-380-7900
  • Fax: 251-281-1161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BECKIE CRAWFORD
Title or Position: VP FINANCE
Credential:
Phone: 251-460-5280