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General NPI Number Information
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NPI Number | 1063516672
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Entity Type | Organization
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Legal Business Name | GASTROINTESTINAL SPECIALISTS LLC
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 2369 STAPLES MILL RD SUITE 200
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City | RICHMOND
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State | VA
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Zip | 23230-2918
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Country | US
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Telephone | 804-285-4465
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Fax |
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Provider Business Mailing Address
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Address Line | 2369 STAPLES MILL RD STE 200
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City | RICHMOND
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State | VA
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Zip | 23230-2918
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Country | US
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Telephone | 804-285-4465
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Fax |
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Authorized Official
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Title or Position | MANAGING PHYSICIAN
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Name | DR. P. FREDERICK DUCKWORTH
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Credential | MD
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Telephone | 804-285-8206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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