Healthcare Provider Details

I. General information

NPI: 1821046046
Provider Name (Legal Business Name): GASTROINTESTINAL SPECIALISTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 MEMORIAL DR SUITE G10
DALTON GA
30720-8662
US

IV. Provider business mailing address

1107 MEMORIAL DR SUITE G10
DALTON GA
30720-8662
US

V. Phone/Fax

Practice location:
  • Phone: 706-272-4127
  • Fax:
Mailing address:
  • Phone: 706-272-4127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number042739
License Number StateGA

VIII. Authorized Official

Name: LEE M STRAUSS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 706-272-4127