Healthcare Provider Details

I. General information

NPI: 1912950585
Provider Name (Legal Business Name): GASTROINTESTINAL ASSOCIATES, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 PORTLAND ST SUITE 100
COLUMBIA MO
65201-6677
US

IV. Provider business mailing address

210 PORTLAND ST SUITE 100
COLUMBIA MO
65201-6677
US

V. Phone/Fax

Practice location:
  • Phone: 573-777-8818
  • Fax: 573-777-8819
Mailing address:
  • Phone: 573-777-8818
  • Fax: 573-777-8819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROCHELLE MYERS
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 573-550-1028