Healthcare Provider Details

I. General information

NPI: 1346496783
Provider Name (Legal Business Name): ASSOCIATES IN GASTROENTEROLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 ROOSEVELT HWY SUITE 132
COLCHESTER VT
05446-4460
US

IV. Provider business mailing address

875 ROOSEVELT HWY SUITE 132
COLCHESTER VT
05446-4460
US

V. Phone/Fax

Practice location:
  • Phone: 802-864-7483
  • Fax: 802-660-4337
Mailing address:
  • Phone: 802-864-7483
  • Fax: 802-660-4337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ALEX JOHN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 802-864-7483