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General NPI Number Information
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NPI Number | 1215919329
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Entity Type | Organization
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Legal Business Name | GASTRO-INTESTINAL CENTER INC
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 02/26/2014
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Provider Practice Location Address
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Address Line | 405 N UNIVERSITY AVE
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City | LITTLE ROCK
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State | AR
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Zip | 72205-3108
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Country | US
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Telephone | 501-663-1074
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Fax | 501-663-0906
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Provider Business Mailing Address
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Address Line | 405 N UNIVERSITY AVE
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City | LITTLE ROCK
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State | AR
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Zip | 72205-3108
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Country | US
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Telephone | 501-663-1074
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Fax | 501-663-0906
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | BRETT A KIRKMAN
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Credential |
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Telephone | 501-664-2727
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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 |
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License Number State | AR
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