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General NPI Number Information
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NPI Number | 1225698681
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Entity Type | Organization
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Legal Business Name | AFFINITY GASTROENTEROLOGY ASC LLC
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Dates
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Enumeration Date | 06/18/2019
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 3686 GRANDVIEW PKWY STE 610
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City | BIRMINGHAM
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State | AL
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Zip | 35243-3406
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Country | US
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Telephone | 205-971-3700
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Fax | 205-971-3701
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Provider Business Mailing Address
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Address Line | 3686 GRANDVIEW PKWY STE 610
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City | BIRMINGHAM
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State | AL
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Zip | 35243-3406
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AO- DIRECTOR, PROVIDER ENROLLMENT
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Name | KRISTY MUSIC
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Credential |
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Telephone | 615-465-7377
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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 |
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