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General NPI Number Information
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NPI Number | 1023015989
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Entity Type | Organization
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Legal Business Name | TUCSON GASTROENTEROLOGY INSTITUTE, LLC
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Dates
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Enumeration Date | 07/06/2005
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Last Update Date | 07/15/2013
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Provider Practice Location Address
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Address Line | 3040 N. SWAN ROAD STE. A
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City | TUCSON
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State | AZ
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Zip | 85712
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Country | US
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Telephone | 520-327-3454
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Fax | 520-795-4492
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Provider Business Mailing Address
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Address Line | 3040 N. SWAN ROAD STE. A
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City | TUCSON
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State | AZ
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Zip | 85712
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Country | US
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Telephone | 520-327-3454
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Fax | 520-795-4492
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JOHN J. MCNERNEY JR.
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Credential | M.D.
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Telephone | 520-327-3454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | OSC-2781
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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